Healthcare Provider Details

I. General information

NPI: 1508590522
Provider Name (Legal Business Name): FRANCES L DAVIS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/14/2022
Last Update Date: 07/14/2022
Certification Date: 07/14/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12110 CLAYTON RD
SAINT LOUIS MO
63131-2599
US

IV. Provider business mailing address

5347 DEVONSHIRE AVE
SAINT LOUIS MO
63109-2305
US

V. Phone/Fax

Practice location:
  • Phone: 314-989-8900
  • Fax:
Mailing address:
  • Phone: 314-619-9356
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041S0200X
TaxonomySchool Social Worker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: