Individual
TASHA M DAVIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
6885 SCOTCH LAKE DR, WEST BLOOMFIELD, MI 48324-3984
(248) 825-5537
Mailing address
6885 SCOTCH LAKE DR, WEST BLOOMFIELD, MI 48324-3984
(248) 825-5537
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
4703103622
MI
Other
Enumeration date
11/11/2012
Last updated
11/11/2012
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