Individual
RENISHA LASHAY DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LSW
Contact information
Practice address
12 N 64TH ST, BELLEVILLE, IL 62223-3809
(618) 877-4420
Mailing address
1003 MARTIN LUTHER KING DR, BLOOMINGTON, IL 61701-1429
(618) 877-4420
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
150.117150
IL
Other
Enumeration date
07/31/2025
Last updated
07/31/2025
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