Individual
MRS. DAWANDA DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
31 W 155TH ST, HARVEY, IL 60426-3556
(708) 596-5177
Mailing address
31 W 155TH ST, HARVEY, IL 60426-3556
(085) 965-1777
(708) 596-5518
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
178.015202
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
178015202
—
IL
Enumeration date
09/16/2019
Last updated
07/07/2021
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