Individual
GLORIA JEAN DAVIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW, PHD
Contact information
Practice address
1804 N PORTER ST, STUTTGART, AR 72160-2640
(870) 830-3409
Mailing address
1804 N PORTER ST, STUTTGART, AR 72160-2640
(870) 830-3409
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
C-63
AR
Other
Enumeration date
08/11/2020
Last updated
08/11/2020
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