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Individual

KAREN DAVIS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.ED.,CCC-SLP

Contact information

Practice address
582C FARRINGDOM ST, LUMBERTON, NC 28358-2615
(910) 735-1101
(910) 735-1103
Mailing address
582C FARRINGDOM ST, LUMBERTON, NC 28358-2615
(910) 735-1101
(910) 735-1103

Taxonomy

Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
10621
NC
235Z00000X
Speech-Language Pathologist
SLP005365
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
000961683D
GA
Enumeration date
12/05/2006
Last updated
11/25/2013
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