| NPI | 1255842993 |
|---|---|
| Former Name | KOREENA DAWN DAVIS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional |
| Additional Taxonomies | 101Y00000X Counselor |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) | |
| 101YM0800X Counselor, Mental Health | |
| 251S00000X | |
| Enumeration Date | 2017-10-20 |
| Last Update Date | 2023-08-07 |