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Individual

MRS. KENDRAH JORDAN DAVIS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
BHPP

Contact information

Practice address
3226 SOUTH LAKESIDE DRIVE, TUCSON, AZ 85730
(520) 409-6566
Mailing address
3226 S. LAKESIDE DR., TUCSON, AZ 85730
(520) 409-6566

Taxonomy

Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
2485644
AZ

Other

Enumeration date
09/19/2012
Last updated
09/19/2012
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