Individual
MRS. LORI ALICIA DAVIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
SLP
Contact information
Practice address
149 WOODLAND DR, JUNCTION CITY, AR 71749-9505
(870) 310-4668
Mailing address
149 WOODLAND DR, JUNCTION CITY, AR 71749-9505
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
P8318
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
183269721
—
AR
Enumeration date
10/06/2010
Last updated
10/06/2010
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