Individual
MRS. TOMMIE NELL DAVIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1521 SUNNY GLEN ST, FORT WORTH, TX 76134-4853
(817) 238-3961
Mailing address
PO BOX 6691, FORT WORTH, TX 76115-0691
(817) 238-3961
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
TX
Other
Enumeration date
01/20/2009
Last updated
01/20/2009
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