Individual
MRS. PAQUETTA MARIA DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2925 RUSSELL ST, DETROIT, MI 48207-4825
(313) 396-5300
Mailing address
2925 RUSSELL ST, DETROIT, MI 48207-4825
(313) 396-5300
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
MI
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
10/06/2014
Last updated
01/21/2023
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