Individual
JAKIA MASHAY DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC-IT
Contact information
Practice address
1717 TAYLOR AVE, RACINE, WI 53403-2405
(262) 638-6635
Mailing address
1717 TAYLOR AVE, RACINE, WI 53403-2405
(262) 638-6635
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
7268
WI
Other
Enumeration date
10/23/2023
Last updated
10/23/2023
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