Individual
LISA SHONDELL DAVIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.T.
Contact information
Practice address
1319 W LAWRENCE AVE, SPRINGFIELD, IL 62704-2315
(217) 891-4246
Mailing address
1319 W LAWRENCE AVE, SPRINGFIELD, IL 62704-2315
(217) 891-4246
Taxonomy
Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
Primary
—
—
Other
Enumeration date
09/28/2010
Last updated
09/28/2010
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