Most Relevant Information
Provider Data
| NPI Number: | 1003379611 |
| Provider Name: | NICHOLE DAVIS |
| Entity Type: | Individual |
| Taxonomy Code: | 101YA0400X |
| Specialty: | Counselor |
| License Number: |
Most Important Dates
| Enumeration Date: | 04/10/2019 |
| Last Updated: | 04/10/2019 |
Provider Practice Location
5005 BOWLING ST SW STE C
CEDAR RAPIDS
IA
524045070
Practice Location Phone/Fax
| Phone: | 3195313824 |
| Fax: |
Provider Mailing Location
5005 BOWLING ST SW STE C
CEDAR RAPIDS
IA
524045070
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |