Individual
KEVIN ALONZO DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MS, LADC1, CCFC
Contact information
Practice address
10 MEADOWBROOK RD, BROCKTON, MA 02301-7122
(508) 742-4400
(508) 408-6175
Mailing address
10 MEADOWBROOK RD, BROCKTON, MA 02301-7122
(508) 742-4400
(508) 408-6175
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
2415
MA
Other
Enumeration date
07/16/2020
Last updated
07/16/2020
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