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NPI Code Detail

MEDICARE: MRS. CRISTY CATHERINE DAVIS M.S, CCC-SLP

MEDICARE: MRS. CRISTY CATHERINE DAVIS M.S, 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
1235Z00000XSpeech-Language PathologistSL013883PA

General Provider Information

NPI Number : 1053853721
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. CRISTY CATHERINE DAVIS M.S, CCC-SLP
Provider Business Mailing Address
First Line : 700 LEONARD ST
Second Line :
City : CLEARFIELD
State : PA
Zip : 16830-3245
Country : US
Telephone Number : 814-765-7546
Fax Number :
Provider Business Practice Location Address
First Line : 700 LEONARD ST
Second Line :
City : CLEARFIELD
State : PA
Zip : 16830-3245
Country : US
Telephone Number : 814-765-7546
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/13/2016
Last Update Date : 09/21/2018

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