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General NPI Number Information
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NPI Number | 1104395748
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Entity Type | Individual
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Provider Name | SHERRIE LATRICE DAVIS CCC--SLP
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Gender | Female
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Dates
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Enumeration Date | 11/13/2018
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Last Update Date | 04/03/2020
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Provider Practice Location Address
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Address Line | 3074 HICKORY VALLEY RD
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City | CHATTANOOGA
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State | TN
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Zip | 37421-1273
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Country | US
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Telephone | 423-498-7020
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Fax |
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Provider Business Mailing Address
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Address Line | 6623 SAWTOOTH DR
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City | OOLTEWAH
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State | TN
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Zip | 37363-5865
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Country | US
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Telephone | 859-552-1053
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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 | SLP010302
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | SA16603
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | 0000002990
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License Number State | TN
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