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1578684775
THEORA RIVERS DAVIS
JAMAICA, NY
NPI
1578684775
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
1041C0700X Social Worker Clinical
(Licence: NY R038262)
Enumeration Date
2007-04-03
Last Update Date
2007-07-08
Business Address
THEORA RIVERS DAVIS LCSW
8268 164TH ST
JAMAICA, NY 11432-1121
Phone number: 718-883-3225
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Mailing Address
THEORA RIVERS DAVIS LCSW
7901 BROADWAY MANAGED CARE, D1-01
ELMHURST, NY 11373-1329
Phone number: 718-334-1921
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