Individual
LEILA DIANE DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
180 FAIRFIELD AVE, BRIDGEPORT, CT 06604-4252
(203) 394-6529
Mailing address
511 MAIN ST APT 24, WEST HAVEN, CT 06516-4253
(203) 841-5647
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
—
—
Other
Enumeration date
09/13/2023
Last updated
09/13/2023
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