Healthcare Provider Details

I. General information

NPI: 1356106900
Provider Name (Legal Business Name): YOLANDA RENEE DAVIS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/13/2024
Last Update Date: 12/16/2025
Certification Date: 12/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2612 BRIARBERRY PL
VESTAVIA AL
35226-3816
US

IV. Provider business mailing address

2612 BRIARBERRY PL
VESTAVIA AL
35226-3816
US

V. Phone/Fax

Practice location:
  • Phone: 205-706-7110
  • Fax:
Mailing address:
  • Phone: 205-706-7110
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: