Individual
MARY REBEKAH DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCADC
Contact information
Practice address
645 S ROY WILKINS AVE, LOUISVILLE, KY 40203-2072
(502) 583-4092
Mailing address
645 S ROY WILKINS AVE, LOUISVILLE, KY 40203-2072
(502) 583-4092
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
261521
KY
Other
Enumeration date
08/04/2020
Last updated
08/04/2020
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