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General NPI Number Information
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NPI Number | 1023049566
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Entity Type | Individual
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Provider Name | KAREN KAYLENE DAVIS M. A.
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Gender | Female
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Dates
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Enumeration Date | 07/05/2006
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Last Update Date | 12/20/2024
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Provider Practice Location Address
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Address Line | 4001 DERBY LN
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City | RAPID CITY
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State | SD
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Zip | 57701-2138
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Country | US
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Telephone | 605-716-2466
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Fax |
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Provider Business Mailing Address
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Address Line | 19580 SCOUT LN
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City | SAINT ONGE
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State | SD
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Zip | 57779-7913
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Country | US
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Telephone | 605-491-2832
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | 1132
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License Number State | SD
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