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Individual

MS. SHANA RICHELLE SARAH DAVIS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
C.D.

Contact information

Practice address
7408 MONTANA AVE, HAMMOND, IN 46323-2921
(708) 674-8339
Mailing address
1440 W TAYLOR ST # 2782, CHICAGO, IL 60607-4623
(219) 208-4586

Taxonomy

Speciality
Code
Description
License number
State
374J00000X
Doula
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1427593664
IL
Enumeration date
12/26/2016
Last updated
06/09/2023
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