Individual
MISS TANIKA DAVIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LSW
Contact information
Practice address
440 GLEN ECHO RD, PHILADELPHIA, PA 19119-2914
(267) 626-3091
(215) 242-9119
Mailing address
440 GLEN ECHO RD, PHILADELPHIA, PA 19119-2914
(267) 626-3091
(215) 242-9119
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
SW122461
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1012180030
—
PA
Enumeration date
02/23/2010
Last updated
02/23/2010
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