Individual
LATISHIA RAE DAVIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NCC, LPC
Contact information
Practice address
118 S CHERRY ST STE D, KERNERSVILLE, NC 27284-2764
(336) 618-6021
Mailing address
118 S CHERRY ST, KERNERSVILLE, NC 27284-2023
(336) 618-6021
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
8671
NC
Other
Enumeration date
08/28/2012
Last updated
12/19/2013
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