| NPI | 1831690593 |
|---|---|
| Former Name | LATOSHA R DAVIS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: IL 149.019998) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: MO 2019003940) |
| Enumeration Date | 2018-02-27 |
| Last Update Date | 2025-01-02 |