Healthcare Provider Details

I. General information

NPI: 1396350435
Provider Name (Legal Business Name): AUBRIAUNA DAVASHER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/15/2020
Last Update Date: 02/22/2023
Certification Date: 02/22/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

829 HALBERT ST
MALVERN AR
72104-2607
US

IV. Provider business mailing address

311 WHITTINGTON AVE
HOT SPRINGS AR
71901-3407
US

V. Phone/Fax

Practice location:
  • Phone: 501-332-4400
  • Fax: 501-624-7498
Mailing address:
  • Phone: 501-623-3477
  • Fax: 501-624-7498

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number11911-M
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: