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Individual

DAVARRES ALEXANDER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
QMHP

Contact information

Practice address
9913 SHELBYVILLE RD STE 103, LOUISVILLE, KY 40223-2902
(980) 777-0586
Mailing address
9913 SHELBYVILLE RD STE 103, LOUISVILLE, KY 40223-2902
(980) 777-0586

Taxonomy

Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
KY
175T00000X
Peer Specialist
KY

Other

Enumeration date
08/20/2019
Last updated
03/16/2025
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