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Individual

MRS. DAWYA WILSON DAVIS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.H.S.

Contact information

Practice address
2460 COLLEGE DRIVE, BATON ROUGE, LA 70808
(225) 239-5293
(225) 239-5439
Mailing address
2460 COLLEGE DRIVE, BATON ROUGE, LA 70808
(225) 239-5293
(225) 239-5439

Taxonomy

Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
LA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
601008607
LA
Enumeration date
01/02/2019
Last updated
05/17/2019
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