Individual
MS. MICHELE ELAINE DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
17434 ROY ST, LANSING, IL 60438-1351
(708) 359-9817
(708) 895-1210
Mailing address
17434 ROY ST, LANSING, IL 60438-1351
(708) 359-9817
(708) 895-1210
Taxonomy
Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
Primary
974440764
IL
Other
Enumeration date
08/10/2009
Last updated
08/10/2009
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