Individual
TRACY DAVIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
10021 SW 12TH ST, PEMBROKE PINES, FL 33025-3615
(561) 945-5060
Mailing address
10021 SW 12TH ST, PEMBROKE PINES, FL 33025-3615
(561) 945-5060
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
—
—
Other
Enumeration date
08/17/2023
Last updated
08/17/2023
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