Individual
SUSAN DAVIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
925 BEAR CORBITT RD, BEAR, DE 19701-1323
(024) 542-4003
Mailing address
112 W SHETLAND CT, NEWARK, DE 19711-1502
(727) 348-6019
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
O1-0001732
DE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
886414400
—
FL
Enumeration date
05/21/2007
Last updated
09/16/2019
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