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Individual

MR. CLEASTER DAVIS SR.

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
SOCIAL WORKER

Contact information

Practice address
1811 EXECUTIVE DR STE O, INDIANAPOLIS, IN 46241-4361
(317) 672-2621
Mailing address
1811 EXECUTIVE DR STE O, INDIANAPOLIS, IN 46241-4361
(317) 672-2621

Taxonomy

Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
33001935A

Other

Enumeration date
02/08/2018
Last updated
02/08/2018
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