Whalio Doctors

NPI 1558778936

Willie Davis, RKT

Practitioner Developmentally Disabled Services Day Training Agency Hattiesbiurg, MS

Practice location

Address
701 Duke Ave., Hattiesbiurg, MS 39401
Phone
(601) 550-1164
Mailing address
701 Duke Ave, Hattiesburg, MS 39401-4060

Registered specialties

Developmentally Disabled Services Day Training Agency Primary
Agencies Taxonomy 251C00000X Licence 1907 (IL)

Registry record

NPI
1558778936
Entity type
Individual
Sex (as registered)
Male
NPI issued
17 Jul 2014
Record last updated
17 Jul 2014

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.