Individual
ROSE DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA
Contact information
Practice address
5900 HOHMAN AVE, HAMMOND, IN 46320-2423
(219) 931-0427
Mailing address
324 S MARYLAND AVE, GLENWOOD, IL 60425-2121
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
10/23/2009
Last updated
10/23/2009
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