MEDICARE: MALERIE 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
1	235Z00000X	Speech-Language Pathologist	7101005761	MI

General Provider Information

NPI Number	:	1811465552
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MALERIE DAVIS

Provider Business Mailing Address
First Line	:	36599 LODGE DR
Second Line	:
City	:	STERLING HEIGHTS
State	:	MI
Zip	:	48312-3319
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	36599 LODGE DR
Second Line	:
City	:	STERLING HEIGHTS
State	:	MI
Zip	:	48312-3319
Country	:	US
Telephone Number	:	586-855-2414
Fax Number	:

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

Provider Enumeration Date	:	11/12/2018
Last Update Date	:	02/07/2024

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Directions to “ MALERIE DAVIS ” Practice Location

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