Individual
BRANDI MAE' LON DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
QBHP
Contact information
Practice address
1815 PLEASANT GROVE ROAD, JONESBORO, AR 72405-7870
(870) 933-6886
(870) 933-9395
Mailing address
1815 PLEASANT GROVE ROAD, JONESBORO, AR 72405-7870
(870) 933-6886
(870) 933-9395
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
QBHP
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
197871795
—
AR
Enumeration date
07/10/2013
Last updated
07/19/2021
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