Individual
LASHANDA MARIE DAVIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
14521 JUSTINE ST, HARVEY, IL 60426-1241
(708) 252-0589
Mailing address
14521 JUSTINE ST, HARVEY, IL 60426
(708) 252-0589
Taxonomy
Speciality
Code
Description
License number
State
171000000X
Military Health Care Provider
—
—
374U00000X
Home Health Aide
Primary
—
—
Other
Enumeration date
07/12/2023
Last updated
07/12/2023
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