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General NPI Number Information
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NPI Number | 1225847858
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Entity Type | Individual
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Provider Name | ANNA MARIE DAVIDSON
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Gender | Female
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Dates
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Enumeration Date | 01/07/2025
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Last Update Date | 08/13/2025
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Provider Practice Location Address
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Address Line | 4040 BEACON ST
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City | KINGSLEY
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State | MI
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Zip | 49649-9548
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Country | US
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Telephone | 231-263-1350
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Fax |
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Provider Business Mailing Address
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Address Line | 769 CLYDE LEE DR
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City | TRAVERSE CITY
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State | MI
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Zip | 49696-8680
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Country | US
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Telephone | 231-463-3233
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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 | 7152001107
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License Number State | MI
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