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Laquanda Petoyce Davis

Social Worker

Behavioral Health & Social Service Providers

22170 W 9 Mile Rd, Southfield, MI 48033-6007

PECOS Enrollment

This provider is enrolled in PECOS as LAQUANDA DAVIS.

Based on the most recent information from CMS, provider Laquanda Petoyce Davis is legally eligible to order and refer claims for Part B and DME services only.

Part B
Medicare Part B
Enrolled
HHA
Home Health Agency
Not Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Not Enrolled

CMS last updated its PECOS records yesterday at 11:21 AM.

Profile Details

Provider ID
1043334055
Provider Type
Individual
Full Name
Davis, Laquanda Petoyce
Title
Mrs.
Credential
LMSW

Gender
Female
Sole Proprietor
No
Enumeration Date
3/16/2007
Last Updated
11/21/2013

Contact Information

Practice Location

22170 W 9 Mile Rd, Southfield, MI 48033-6007

(248) 475-6800

(248) 475-6403

Mailing Location

22170 W 9 Mile Rd, Southfield, MI 48033-6007

(248) 372-6800

(248) 475-6403

Provider Taxonomies

Code	Description	License
Code 1041C0700X Primary	Description Social Worker Behavioral Health & Social Service Providers	License 6801086239 Michigan

Laquanda Petoyce Davis

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

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Code

Description

License

Code

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