Individual
CAROL LOUISE DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN, LCSW
Contact information
Practice address
303 E VANDERBILT WAY, SAN BERNARDINO, CA 92415-0928
(909) 386-8207
Mailing address
303 E VANDERBILT WAY, SAN BERNARDINO, CA 92415-0928
(909) 386-8207
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
LCS23451
CA
163W00000X
Registered Nurse
Primary
396826
CA
Other
Enumeration date
01/29/2007
Last updated
03/04/2015
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