Individual
DIANE DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA, CPC-I, R-DMT
Contact information
Practice address
6730 S FORT APACHE RD, LAS VEGAS, NV 89148-5396
(702) 665-5593
Mailing address
6730 S FORT APACHE RD, LAS VEGAS, NV 89148-5396
(702) 665-5593
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
CI5233
NV
101YP2500X
Professional Counselor
—
NV
225600000X
Dance Therapist
2758
—
Other
Enumeration date
05/25/2022
Last updated
01/27/2023
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