Individual
ETHEL DAVIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MHS
Contact information
Practice address
2744 ELMHURST ST, SHREVEPORT, LA 71108-4518
(318) 220-6626
Mailing address
2744 ELMHURST ST, SHREVEPORT, LA 71108-4518
(318) 220-6626
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
09/30/2016
Last updated
09/30/2016
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