Individual
STELLANDA M DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMSW, MFT
Contact information
Practice address
17280 HIGHWAY 17 SOUTH, LEXINGTON, MS 39095-0479
(662) 834-1857
(662) 834-4937
Mailing address
8596 BROZVILLE RD, LEXINGTON, MS 39095-6856
(662) 834-4061
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
M4543
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
M4543
LICENSE SOCIAL WORKER
MS
01
—
T0261
MASTER LICENSE SOCIAL WOR
MS
Enumeration date
05/21/2007
Last updated
07/08/2007
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