Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YS0200X | School Counselor | 5566 | NC |
NPI | 1073832820 |
---|---|
Provider Name | Devon Davis |
First Address | Winston Salem, NC 27106-5852 |
Second Address | Winston Salem, NC 27106-5115 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/05/2010 |
Last Update Date | 19/05/2010 |