Individual
SHIRLEY JOSEPH-DAVISAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
GSW
Contact information
Practice address
19404 N 10TH ST, COVINGTON, LA 70433-8892
(985) 871-1380
Mailing address
19404 N 10TH ST, COVINGTON, LA 70433-8892
(985) 871-1380
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
9653
LA
Other
Enumeration date
03/31/2008
Last updated
03/31/2008
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