Individual
LISA E DAVIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1206 HIGHWAY 411, VONORE, TN 37885-2455
(423) 884-7271
(423) 884-3277
Mailing address
1206 HIGHWAY 411, VONORE, TN 37885-2455
(423) 884-7271
(423) 884-3277
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
LSW0000000508
TN
1041C0700X
Clinical Social Worker
Primary
0508
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000146732
B.C.B.S.T. NUMBER
TN
05
—
1508351
—
TN
05
—
3693562
—
TN
01
—
4045434
B.C.B.S.T.N.
TN
Enumeration date
12/14/2006
Last updated
08/17/2010
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