MEDICARE: KATHERINE ANNETTE DAVIS M.ED., CCC-SLP

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	2202005664	VA

General Provider Information

NPI Number	:	1033952684
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KATHERINE ANNETTE DAVIS M.ED., CCC-SLP

Provider Business Mailing Address
First Line	:	10035 W JAMES ANDERSON HWY
Second Line	:
City	:	BUCKINGHAM
State	:	VA
Zip	:	23921-3150
Country	:	US
Telephone Number	:	434-547-9398
Fax Number	:

Provider Business Practice Location Address
First Line	:	15595 W JAMES ANDERSON HWY
Second Line	:
City	:	BUCKINGHAM
State	:	VA
Zip	:	23921-3118
Country	:	US
Telephone Number	:	434-969-6100
Fax Number	:

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

Provider Enumeration Date	:	06/13/2024
Last Update Date	:	06/13/2024

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Directions to “ KATHERINE ANNETTE DAVIS M.ED., CCC-SLP” Practice Location

Language	Start Address	Practice Location

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