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Individual

BRIAN W DAVIS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
LCSW

Contact information

Practice address
350 SALEM RD STE 1, CONWAY, AR 72034-6166
(501) 336-8300
(479) 890-5364
Mailing address
110 SKYLINE DRIVE, RUSSELLVILLE, AR 72801
(479) 967-5570
(479) 890-5364

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
1930C
AL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
51532255
BCBS
AL
01
51532854
FEDERAL BCBS
AL
Enumeration date
05/30/2006
Last updated
07/21/2022
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