Individual
DEJANEIRO DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1401 HUDSON LN, SUITE 202, MONROE, LA 71201-6068
(318) 323-1300
Mailing address
1912 N 7TH ST, APT 1, WEST MONROE, LA 71291-4118
(318) 348-8848
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
01/11/2017
Last updated
01/11/2017
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