Mr. Willie Davis Jr., RKT

Individual provider Developmentally Disabled Services Day Training Agency · NPI 1558778936

Mr. Willie Davis Jr., RKT is a Developmentally Disabled Services Day Training Agency in Hattiesbiurg, Mississippi. Practices as a sole proprietor. Licensed in Illinois.

Licensed in: IL
In the registry since: 2014

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Practice location Address checks out

701 Duke Ave
Hattiesbiurg, MS 39401 Not confirmed with CMS for 12 years — call before visiting
Phone: (601) 550-1164

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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Developmentally Disabled Services Day Training Agency (primary)	Taxonomy 251C00000X · Licence 1907 (IL)

Record details

NPI number	1558778936
Entity type	Individual (Type 1)
Gender	Male
Credentials	RKT
Sole proprietor	Yes
NPI enumerated	July 17, 2014
Last updated in NPPES	July 17, 2014