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Individual

MRS. KELLIE MERIDETH DAVISON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LCSW

Contact information

Practice address
6127 HIGHWAY 49 N STE D, BROOKLAND, AR 72417-8650
(870) 219-7450
Mailing address
6127 HIGHWAY 49 N STE D, BROOKLAND, AR 72417-8650
(870) 336-2937
(870) 336-2938

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
6554-C
AR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
173840795
AR
01
5AR15
BCBS
AR
Enumeration date
09/25/2008
Last updated
04/30/2021
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