Individual
DERRICK DEWAYNER DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1935 LAKELAND DR # 900, JACKSON, MS 39216-5028
(601) 718-2468
(601) 718-2487
Mailing address
1935 LAKELAND DR, JACKSON, MS 39216-5028
(601) 718-2468
(601) 718-2487
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
04/15/2026
Last updated
04/15/2026
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