Individual
JAQUOYA SHANAE DAVIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1 UNIVERSITY RD, PEMBROKE, NC 28372-8699
(984) 286-7658
Mailing address
324 S WILMINGTON ST # 207, RALEIGH, NC 27601-1847
(984) 286-7658
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
12/19/2022
Last updated
12/19/2022
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