Individual
MADISON DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, CCC-SLP
Contact information
Practice address
621 LAKE ST NE, WISE, VA 24293-7920
(276) 328-6113
Mailing address
305 LOCKHART FLATS LOOP, CLINTWOOD, VA 24228-7026
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
2202010459
VA
Other
Enumeration date
07/26/2022
Last updated
07/26/2022
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