Individual
KALEAH ROSE DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LADC
Contact information
Practice address
1900 SILVER LAKE RD NW STE 110, NEW BRIGHTON, MN 55112-1789
(651) 628-9566
Mailing address
604 N HIGH ST, RUSHFORD, MN 55971-9111
(507) 458-9606
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
307113
MN
Other
Enumeration date
08/12/2024
Last updated
08/12/2024
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