Individual
CARLA R DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1015 W LAWRENCE AVE FL 2, CHICAGO, IL 60640-5017
(773) 275-2586
Mailing address
4750 N SHERIDAN RD FL 4, CHICAGO, IL 60640-7528
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
29186
IL
Other
Enumeration date
12/18/2017
Last updated
12/18/2017
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