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NPI Code Detail

MEDICARE: JOCELYNN HOSEA-DAVIS M.S.W., S.A.C.I.T.

MEDICARE: JOCELYNN HOSEA-DAVIS M.S.W., S.A.C.I.T.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YA0400XAddiction (Substance Use Disorder) CounselorSACIT 15828-130WI

General Provider Information

NPI Number : 1013211895
Entity Type Code : Individual
Provider Name (Legal Business Name) : JOCELYNN HOSEA-DAVIS M.S.W., S.A.C.I.T.
Provider Business Mailing Address
First Line : 2618 N BREMEN ST
Second Line :
City : MILWAUKEE
State : WI
Zip : 53212-3003
Country : US
Telephone Number : 414-977-1200
Fax Number : 414-962-2305
Provider Business Practice Location Address
First Line : 2618 N BREMEN ST
Second Line :
City : MILWAUKEE
State : WI
Zip : 53212-3003
Country : US
Telephone Number : 414-977-1200
Fax Number : 414-962-2305
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/07/2011
Last Update Date : 01/20/2011

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