Individual
MRS. RENITA DERCEL DAVIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSW, MED
Contact information
Practice address
200 W COUNTRY WALK DR, ROUND LAKE BEACH, IL 60073-4009
(847) 668-7456
(847) 356-1306
Mailing address
1940 N MUNICIPAL WAY UNIT 991, ROUND LAKE BEACH, IL 60073-7939
(847) 668-7456
(847) 356-1306
Taxonomy
Speciality
Code
Description
License number
State
1041S0200X
School Social Worker
Primary
—
IL
Other
Enumeration date
04/05/2021
Last updated
07/22/2021
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