Individual
ANDREA D DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.ED., LPCA
Contact information
Practice address
104 N TREY CT, VINE GROVE, KY 40175-8688
(270) 272-3345
Mailing address
104 N TREY CT, VINE GROVE, KY 40175-8688
(270) 272-3345
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
267994
KY
101YM0800X
Mental Health Counselor
C.2204076
OH
Other
Enumeration date
03/29/2022
Last updated
03/29/2022
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