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Individual

TIMOTHY O DAVIS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
LSCSW

Contact information

Practice address
2214 CANTERBURY DR, STE 300, HAYS, KS 67601-2386
(785) 623-5160
Mailing address
2214 CANTERBURY DR, STE 300, HAYS, KS 67601-2397

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
2223
KS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
069645
MEDICARE ID
KS
05
100425770A
KS
Enumeration date
11/08/2006
Last updated
07/18/2019
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