Individual
AMY DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1851 COLUMBUS ST, OTTAWA, IL 61350-1528
(815) 326-5806
Mailing address
1209 ADDIE AVE, OTTAWA, IL 61350-9150
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
149.011544
IL
Other
Enumeration date
08/10/2010
Last updated
08/10/2010
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