| NPI | 1225748189 |
|---|---|
| Former Name | AUTUMN RICHELLE DAVIS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 172V00000X Community Health Worker |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| Enumeration Date | 2022-12-01 |
| Last Update Date | 2023-05-10 |