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Individual

MIRIAM DAVIS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
102 KIRKWOOD LN, YOUNGSVILLE, LA 70592-5325
(337) 451-0787
Mailing address
4400 AMBASSADOR CAFFERY PKWY, STE A PMB #137, LAFAYETTE, LA 70508

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
7382
LA
101Y00000X
Counselor
93583
TX
101Y00000X
Counselor
Primary

Other

Enumeration date
04/19/2017
Last updated
07/06/2025
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