Doctor Name: | AMANDA NICOLE DAVIS |
NPI Number: | 1619214392 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | M.S. CFY-SLP |
License Number: | 8641 |
Business Practice Address: | 2000 W Parkway Dr Russellville, AR - 728022104 |
Business Phone Number: | 4799681599 |
Business Fax Number: | |
Mailing Address: | 154 School St, LONDON |
State: | AR |
Postal Code: | 728479053 |
Phone Number: | 4792934241 |
Fax Number: | |
NPI Enumeration Date: | 01/15/2013 |
NPI Last Update Date: | 01/15/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | 8641 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | AR |
Taxonomy Type: | Speech, Language and Hearing Service Providers |
Taxonomy Classification: | Speech-Language Pathologist |
Taxonomy Specialization: | |
Taxonomy Definition: | A speech pathologist is a person qualified by a master |