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Individual

DIONTE DAVIS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
3140 JUANIPERO WAY STE 101, MEDFORD, OR 97504-8647
(541) 323-4800
Mailing address
23110 LAWSON AVE, WARREN, MI 48089-4473

Taxonomy

Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
171400000X
Health & Wellness Coach
Primary
175T00000X
Peer Specialist

Other

Enumeration date
06/27/2025
Last updated
06/27/2025
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