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General NPI Number Information
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NPI Number | 1386456689
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Entity Type | Individual
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Provider Name | AMYE JEAN DAVIS
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Gender | Female
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Dates
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Enumeration Date | 01/23/2025
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Last Update Date | 01/23/2025
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Provider Practice Location Address
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Address Line | 707 ARMSTRONG RD
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City | LANSING
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State | MI
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Zip | 48911-3906
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Country | US
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Telephone | 517-393-5680
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Fax |
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Provider Business Mailing Address
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Address Line | 428 E BLAIR ST
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City | HASTINGS
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State | MI
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Zip | 49058-1503
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Country | US
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Telephone | 517-213-9275
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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 | 224Z00000X
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Taxonomy Name | Occupational Therapy Assistant
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License Number | 5202010099
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License Number State | MI
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