Individual
MRS. LATANYA DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PLPC
Contact information
Practice address
9378 OLIVE BLVD STE 317, SAINT LOUIS, MO 63132-3224
(252) 258-6666
Mailing address
1263 CHATEAU WOODS DR, FERGUSON, MO 63135-1357
(252) 258-6666
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
2019037898
MO
Other
Enumeration date
10/09/2019
Last updated
10/09/2019
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