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General NPI Number Information
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NPI Number | 1457522823
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Entity Type | Individual
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Provider Name | NATASHA LYNET DAVIS LCSW
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Gender | Female
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Dates
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Enumeration Date | 03/13/2008
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Last Update Date | 03/13/2008
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Provider Practice Location Address
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Address Line | 7950 MARTIN LOOP
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City | FORT BENNING
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State | GA
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Zip | 31905-5647
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Country | US
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Telephone | 706-544-2516
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Fax |
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Provider Business Mailing Address
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Address Line | 718 WOODBERRY PL
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City | DECATUR
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State | GA
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Zip | 30034-5558
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Country | US
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Telephone | 404-345-9977
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 070857-1
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License Number State | NY
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