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Individual

TAQUINA CHANTE DAVIS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
1501 SUMTER ST, COLUMBIA, SC 29201-2829
(803) 296-5990
Mailing address
1289 HEINS RD, BLYTHEWOOD, SC 29016-8924
(803) 528-5090

Taxonomy

Speciality
Code
Description
License number
State
174H00000X
Health Educator
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
174H00000X
SC
Enumeration date
06/30/2020
Last updated
06/30/2020
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