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Individual

LONYEA TENELL DAVIS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
1000 N BURNS ST, MUNCIE, IN 47303-4004
(765) 228-7177
Mailing address
1408 W STIRLING DR, MUNCIE, IN 47304-2245
(765) 228-7177

Taxonomy

Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
373H00000X
Day Training/Habilitation Specialist

Other

Enumeration date
11/25/2024
Last updated
11/25/2024
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