MEDICARE: DR. RACHEL ELIZABETH DAVIS PH.D.

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	103G00000X	Clinical Neuropsychologist	PY0753	NV
2	103TC2200X	Clinical Child & Adolescent Psychologist	PY0753	NV

General Provider Information

NPI Number	:	1922488121
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. RACHEL ELIZABETH DAVIS PH.D.

Provider Business Mailing Address
First Line	:	7341 W CHARLESTON BLVD
Second Line	:	STE. 140
City	:	LAS VEGAS
State	:	NV
Zip	:	89117-1510
Country	:	US
Telephone Number	:	702-776-8990
Fax Number	:	702-776-8548

Provider Business Practice Location Address
First Line	:	7341 W CHARLESTON BLVD
Second Line	:	STE. 140
City	:	LAS VEGAS
State	:	NV
Zip	:	89117-1510
Country	:	US
Telephone Number	:	702-776-8890
Fax Number	:	702-776-8548

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

Provider Enumeration Date	:	06/02/2015
Last Update Date	:	06/13/2015

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