Individual
MRS. MONCHELLE DENISE DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
9317 MADINA PKWY, FORT WAYNE, IN 46825-1134
(260) 418-5962
Mailing address
9317 MADINA PKWY, FORT WAYNE, IN 46825-1134
(260) 418-5962
Taxonomy
Speciality
Code
Description
License number
State
373H00000X
Day Training/Habilitation Specialist
Primary
—
—
Other
Enumeration date
02/19/2020
Last updated
02/19/2020
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