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Individual

TAKESHA DAVIS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
11022 FRONT ST UNIT 102, ORLANDO, FL 32821-4070
(414) 544-3383
Mailing address
11022 FRONT ST UNIT 102, ORLANDO, FL 32821-4070
(414) 544-3383

Taxonomy

Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
Primary

Other

Enumeration date
05/10/2025
Last updated
05/10/2025
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