Individual
MS. JACQUELINE D DAVIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.ED. CCCSLP
Contact information
Practice address
134 WOODCREST CIR, WARNER ROBINS, GA 31093-3034
(478) 929-0513
(478) 929-0513
Mailing address
134 WOODCREST CIR, WARNER ROBINS, GA 31093-3034
(478) 929-0513
(478) 929-0513
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SLP001725
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00661746C
—
GA
Enumeration date
01/29/2007
Last updated
07/09/2007
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