Individual
MISS SHANESHA DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BA
Contact information
Practice address
6309 MACK AVE, DETROIT, MI 48207-2302
(313) 921-4700
(313) 921-4125
Mailing address
6309 MACK AVE, DETROIT, MI 48207-2302
(313) 921-4700
(313) 921-4125
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
D120765765972
BA
MA
Enumeration date
05/02/2007
Last updated
07/08/2007
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