Individual
MARISSA DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1 E SUPERIOR ST STE 306, CHICAGO, IL 60611-2595
(312) 754-9404
Mailing address
8701 W WATERTOWN PLANK RD, MILWAUKEE, WI 53226-3548
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
036.176674
IL
390200000X
Student in an Organized Health Care Education/Training Program
81525-20
WI
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
05/28/2021
Last updated
08/28/2025
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