Individual
JACQUELINE YVETTER SMITH DAVIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
16609 ARCHDALE ST, DETROIT, MI 48235-3416
(313) 974-0175
Mailing address
37450 SCHOOLCRAFT RD, LIVONIA, MI 48150-1082
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
640100361
MI
Other
Enumeration date
01/15/2020
Last updated
01/15/2020
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