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Individual

LANA MARLENE DAVIS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
L.C.S.W.

Contact information

Practice address
525 BAY STREET, WALDPORT, OR 97394
(541) 453-3055
Mailing address
9088 NW KINGLET LN, SEAL ROCK, OR 97376-9755
(541) 563-7408

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
L3513
OR

Other

Enumeration date
02/15/2006
Last updated
07/08/2007
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