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NPI Code Detail

MEDICARE: JANETTE DAVIS LMSW

MEDICARE: JANETTE DAVIS LMSW
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
1104100000XSocial Worker1425-MAR

General Provider Information

NPI Number : 1063485662
Entity Type Code : Individual
Provider Name (Legal Business Name) : JANETTE DAVIS LMSW
Provider Business Mailing Address
First Line : 1249 LAKESIDE RD
Second Line :
City : HOT SPRINGS
State : AR
Zip : 71901-7354
Country : US
Telephone Number : 501-262-2766
Fax Number : 501-262-2544
Provider Business Practice Location Address
First Line : 1249 LAKESIDE RD
Second Line :
City : HOT SPRINGS
State : AR
Zip : 71901-7354
Country : US
Telephone Number : 501-262-2766
Fax Number : 501-262-2544
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/13/2006
Last Update Date : 07/29/2015

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Directions to “ JANETTE DAVIS LMSW” Practice Location

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