Individual
MS. JULIANA BROOK DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
TECHNICIAN
Contact information
Practice address
2227 W MAIN ST, STE 3, JACKSONVILLE, AR 72076-4207
(501) 985-9944
(501) 985-6590
Mailing address
2227 W MAIN ST, STE 3, JACKSONVILLE, AR 72076-4207
(501) 985-9944
(501) 985-6590
Taxonomy
Speciality
Code
Description
License number
State
235500000X
Speech/Language/Hearing Specialist/Technologist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
146940002
—
AR
01
—
400522327
IDTF
OK
01
—
400522335
MEDICARE ID
OK
01
—
5C652
MEDICARE ID
AR
01
—
5C724
IDTF
AR
Enumeration date
08/05/2007
Last updated
01/19/2017
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