Individual
KATHLEEN J DAVIDSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCAC
Contact information
Practice address
322 W JEFFERSON ST, PLYMOUTH, IN 46563-1734
(574) 936-3377
(574) 936-3910
Mailing address
8495 E 150 S, KNOX, IN 46534-8396
(219) 928-1944
(574) 936-3910
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
87001530A
IN
Other
Enumeration date
07/22/2014
Last updated
07/22/2014
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