Provider Demographics
NPI:1629722780
Name:PULLEY, DAVISHA (MSW)
Entity Type:Individual
Prefix:
First Name:DAVISHA
Middle Name:
Last Name:PULLEY
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2175 ONEIDA ST
Mailing Address - Street 2:
Mailing Address - City:JOLIET
Mailing Address - State:IL
Mailing Address - Zip Code:60435-6560
Mailing Address - Country:US
Mailing Address - Phone:815-409-4440
Mailing Address - Fax:815-409-4444
Practice Address - Street 1:2175 ONEIDA ST
Practice Address - Street 2:
Practice Address - City:JOLIET
Practice Address - State:IL
Practice Address - Zip Code:60435-6560
Practice Address - Country:US
Practice Address - Phone:815-409-4440
Practice Address - Fax:815-409-4444
Is Sole Proprietor?:No
Enumeration Date:2022-02-08
Last Update Date:2022-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker