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Individual

MS. AMANDA G. DAVIS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MS, CCC-SLP

Contact information

Practice address
4301 W MARKHAM ST, SLOT #621-1, LITTLE ROCK, AR 72205-7199
(501) 526-2286
(501) 526-5005
Mailing address
4301 W MARKHAM ST, SLOT #621-1, LITTLE ROCK, AR 72205-7199
(501) 526-2286
(501) 526-5005

Taxonomy

Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
3221
AR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
515-30958
BLUE CROSS PROVIDER NUMBE
Enumeration date
05/14/2007
Last updated
04/04/2014
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