Individual
DACONTEE J DAVIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMSW
Contact information
Practice address
15 EVERETT ST, EAST ORANGE, NJ 07017-1716
(609) 954-8976
Mailing address
15 EVERETT ST, EAST ORANGE, NJ 07017-1716
(609) 954-8976
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
SW136311
PA
Other
Enumeration date
12/08/2020
Last updated
12/09/2020
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