Doctor Name: | HEATHER DAVIS |
NPI Number: | 1649693250 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | S3836 |
Business Practice Address: | 110 Pioneer Way Magee, MS - 391115501 |
Business Phone Number: | 8662169285 |
Business Fax Number: | |
Mailing Address: | 7125 Capitol Ave, Unit B COLUMBUS |
State: | MS |
Postal Code: | 397057630 |
Phone Number: | |
Fax Number: | |
NPI Enumeration Date: | 02/03/2014 |
NPI Last Update Date: | 03/17/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | S3836 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MS |
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 |