Individual
LINDSEY DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
SAC-IT 18487-130
Contact information
Practice address
2357 W MASON ST, GREEN BAY, WI 54303-4708
(920) 337-6740
Mailing address
2357 W MASON ST, GREEN BAY, WI 54303-4708
(920) 337-6740
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
18487-130
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
42030700
—
WI
Enumeration date
05/01/2018
Last updated
05/01/2018
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