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NPI Code Detail

MEDICARE: DEBORAH DAVIS

MEDICARE: DEBORAH DAVIS
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
11041C0700XClinical Social WorkerCW002080LPA

General Provider Information

NPI Number : 1134519713
Entity Type Code : Individual
Provider Name (Legal Business Name) : DEBORAH DAVIS
Provider Business Mailing Address
First Line : 4100 MAIN ST
Second Line : SUITE 403
City : PHILADELPHIA
State : PA
Zip : 19127-1623
Country : US
Telephone Number : 215-487-3100
Fax Number :
Provider Business Practice Location Address
First Line : 4100 MAIN ST
Second Line : SUITE 403
City : PHILADELPHIA
State : PA
Zip : 19127-1623
Country : US
Telephone Number : 215-487-3100
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/03/2015
Last Update Date : 02/03/2015

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Directions to “ DEBORAH DAVIS ” Practice Location

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