Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103G00000X | Clinical Psychologist | 3730 | WI |
Y | 103TC0700X | Clinical Psychologist | 3730 | WI |
NPI | 1003457896 |
---|---|
Provider Name | Danya Kay Dravis |
First Address | La Crosse, WI 54601-5429 |
Second Address | La Crosse, WI 54601-5429 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/10/2019 |
Last Update Date | 02/10/2019 |