| NPI | 1396901906 |
|---|---|
| Former Name | ELIZABETH SUE DAVIS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: WA LH61453285) |
| Additional Taxonomies | 124Q00000X Dental Hygienist (Licence: SD 978) |
| Enumeration Date | 2008-08-03 |
| Last Update Date | 2023-08-11 |