Individual
ELLA MAMANTA DAVIDSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
904 PANORAMIC WAY, BERKELEY, CA 94704-2540
(845) 705-0371
Mailing address
904 PANORAMIC WAY, BERKELEY, CA 94704-2540
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
08/23/2021
Last updated
08/23/2021
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