Individual
DOMINIQUE NICOLLE DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ITDS
Contact information
Practice address
13014 N DALE MABRY HWY # 659, TAMPA, FL 33618-2808
(813) 215-6275
Mailing address
1568 W WINDY WILLOW DR, ST AUGUSTINE, FL 32092-5098
(904) 217-9732
Taxonomy
Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
Primary
—
—
Other
Enumeration date
05/03/2024
Last updated
11/17/2025
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