Davis, Breonna Lashae

Davis, Breonna Lashae is an individual health care provider with primary practice located at 800 E City Hall Ave , Norfolk VA 23510-2723. She recently has only one registered license in Behavioral Health & Social Service Providers / School, which is considered as her primary health care specialty. Davis, Breonna Lashae can be contacted via phone (270) 366-5765.

Contact Information

Primary practice address
800 E City Hall Ave Norfolk VA 23510-2723
Phone: (270) 366-5765
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / School 103TS0200X 0813000927 Virginia

Profile Details

NPI number 1023513108
LBN Legal business name Davis, Breonna Lashae
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 29th, 2018
Last updated Mar 29th, 2018 - about 6 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1023513108 NPPES
Virginia MEDICAID 31609

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