Individual
MRS. KELLI BLACK DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA, CCC-SLP
Contact information
Practice address
3333 SILAS CREEK PKWY, WINSTON SALEM, NC 27103-3013
(336) 718-6300
Mailing address
2165 MAURINE WAY, WINSTON SALEM, NC 27127-7578
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
6673
NC
Other
Enumeration date
05/18/2007
Last updated
07/08/2007
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