Individual
DESTANAE DAVIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
700 JOHNSON RIDGE RD, ELKIN, NC 28621-2424
(336) 527-7600
Mailing address
700 JOHNSON RIDGE RD, ELKIN, NC 28621-2424
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
13092
NV
Other
Enumeration date
03/28/2023
Last updated
03/28/2023
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