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Individual

BENNAE EMON DAVIS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LPC

Contact information

Practice address
54 MALBONE RD, NEWPORT, RI 02840-1746
(404) 838-8770
Mailing address
PO BOX 4321, MIDDLETOWN, RI 02842-0321
(404) 838-8770

Taxonomy

Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
178-017645
IL

Other

Enumeration date
04/14/2022
Last updated
04/14/2022
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