| NPI | 1962193037 |
|---|---|
| Former Name | SHELLEY F DAVIDSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 172V00000X Community Health Worker |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| Enumeration Date | 2023-05-18 |
| Last Update Date | 2023-07-03 |