Provider Demographics
NPI:1114583408
Name:DAVIS, TRASHAYLA LYNETTE
Entity Type:Individual
Prefix:MS
First Name:TRASHAYLA
Middle Name:LYNETTE
Last Name:DAVIS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:765 E HAMILTON AVE
Mailing Address - Street 2:
Mailing Address - City:FLINT
Mailing Address - State:MI
Mailing Address - Zip Code:48505-4707
Mailing Address - Country:US
Mailing Address - Phone:810-233-5340
Mailing Address - Fax:810-233-3565
Practice Address - Street 1:765 E HAMILTON AVE
Practice Address - Street 2:
Practice Address - City:FLINT
Practice Address - State:MI
Practice Address - Zip Code:48505-4707
Practice Address - Country:US
Practice Address - Phone:810-233-5340
Practice Address - Fax:810-233-3565
Is Sole Proprietor?:No
Enumeration Date:2019-05-13
Last Update Date:2019-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)