Individual
MRS. JENNIFER KINLAW DAVIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSCCC-SLP
Contact information
Practice address
1289 OLIVER ST, FAYETTEVILLE, NC 28304-4450
(910) 483-8331
(910) 483-8335
Mailing address
2606 N EDGEWATER DR, FAYETTEVILLE, NC 28303-5242
(910) 538-6994
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
3451
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0281J
BCBS
NC
05
—
7427697
—
NC
Enumeration date
07/17/2007
Last updated
07/07/2010
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