Doctor Name: | MICHAEL RAE DAVIS |
NPI Number: | 1144239641 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | LISW |
License Number: | 02700 |
Business Practice Address: | 2416 340th St Keokuk, IA - 526329539 |
Business Phone Number: | 3195243560 |
Business Fax Number: | 3198653110 |
Mailing Address: | 2416 340th St, KEOKUK |
State: | IA |
Postal Code: | 526329539 |
Phone Number: | 3195243560 |
Fax Number: | 3198653110 |
NPI Enumeration Date: | 08/05/2006 |
NPI Last Update Date: | 12/22/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1041C0700X |
License Number: | 02700 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | IA |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Social Worker |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: | A social worker who holds a master |