Individual
NOREEN L DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
HIS
Contact information
Practice address
6704 OLD TRAIL RD, FORT WAYNE, IN 46809-2639
(260) 747-0135
Mailing address
6704 OLD TRAIL RD, FORT WAYNE, IN 46809-2639
(260) 747-0135
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3920252678
NONE
IN
01
—
3920252678
UNKNOWN
—
Enumeration date
02/03/2021
Last updated
02/03/2021
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