Provider Demographics
NPI:1881336220
Name:DAVY, KEESHA (PEER SUPPORT)
Entity type:Individual
Prefix:MRS
First Name:KEESHA
Middle Name:
Last Name:DAVY
Suffix:
Gender:F
Credentials:PEER SUPPORT
Other - Prefix:MRS
Other - First Name:KEESHA
Other - Middle Name:
Other - Last Name:LEGRAND
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:20465 W DANIEL PL
Mailing Address - Street 2:
Mailing Address - City:BUCKEYE
Mailing Address - State:AZ
Mailing Address - Zip Code:85396-3648
Mailing Address - Country:US
Mailing Address - Phone:334-301-5157
Mailing Address - Fax:
Practice Address - Street 1:20465 W DANIEL PL
Practice Address - Street 2:
Practice Address - City:BUCKEYE
Practice Address - State:AZ
Practice Address - Zip Code:85396-3648
Practice Address - Country:US
Practice Address - Phone:334-301-5157
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-04-07
Last Update Date:2022-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ175T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist