Individual
MS. DIANE ELIZABETH DAVIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LBSW
Contact information
Practice address
414 S BURDICK ST, SUITE 200, KALAMAZOO, MI 49007-6219
(269) 381-4446
(269) 381-4457
Mailing address
414 S. BURDICK STREET, SUITE 200, KALAMAZOO, MI 49007-6219
(269) 381-4446
(269) 381-4457
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
6802068864
MI
Other
Enumeration date
06/22/2012
Last updated
06/22/2012
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