| NPI | 1114572831 |
|---|---|
| Professional Name | DUSTIN JAMES DAVIS |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 167G00000X Licensed Psychiatric Technician |
| Additional Taxonomies | 146N00000X Emergency Medical Technician, Basic |
| 101YA0400X Counselor Addiction (Substance Use Disorder) | |
| Enumeration Date | 2019-08-08 |
| Last Update Date | 2019-08-08 |