Individual
LAUREN HALL DAVIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ITDS
Contact information
Practice address
4751 APACHE AVE, JACKSONVILLE, FL 32210-7659
(904) 307-4594
Mailing address
4751 APACHE AVE, JACKSONVILLE, FL 32210-7659
(904) 307-4594
Taxonomy
Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
222Q00000X
—
FL
Enumeration date
10/25/2011
Last updated
01/18/2012
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