Individual
MIKE DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CIT
Contact information
Practice address
564 BRAXTON RD, DODSON, LA 71422-3880
(318) 413-4436
Mailing address
564 BRAXTON RD, DODSON, LA 71422-3880
(318) 413-4436
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
CIT-5753
LA
Other
Enumeration date
02/13/2024
Last updated
02/13/2024
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