Individual
COURTNEY DAVIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
9317 MADINA PKWY, FORT WAYNE, IN 46825-1134
(260) 580-1996
Mailing address
429 E DUPONT RD # 97, FORT WAYNE, IN 46825-2051
(260) 580-1996
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
03/28/2022
Last updated
03/28/2022
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