MEDICARE: KAY D. DAVIS M.A.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	235Z00000X	Speech-Language Pathologist	552	LA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1003930975
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KAY D. DAVIS M.A.

Provider Business Mailing Address
First Line	:	3725 LAKE TRAIL DR
Second Line	:
City	:	KENNER
State	:	LA
Zip	:	70065-3313
Country	:	US
Telephone Number	:	504-616-7710
Fax Number	:	504-885-3225

Provider Business Practice Location Address
First Line	:	3725 LAKE TRAIL DR
Second Line	:
City	:	KENNER
State	:	LA
Zip	:	70065-3313
Country	:	US
Telephone Number	:	504-616-7710
Fax Number	:	504-885-3225

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/18/2007
Last Update Date	:	07/09/2007

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Directions to “ KAY D. DAVIS M.A.” Practice Location

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