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General NPI Number Information
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NPI Number | 1528825726
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Entity Type | Individual
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Provider Name | REINA DAVISON PHD, LCSW, LISW
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Gender | Female
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Dates
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Enumeration Date | 03/04/2024
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Last Update Date | 03/04/2024
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Provider Practice Location Address
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Address Line | US AIR FORCE MEDICAL GROUP 431 MEADOWLARK STREET
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City | SUMTER
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State | SC
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Zip | 29152
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Country | US
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Telephone | 803-895-4222
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Fax |
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Provider Business Mailing Address
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Address Line | 4235 CAMDEN HWY UNIT 4
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City | DALZELL
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State | SC
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Zip | 29040-2000
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Country | US
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Telephone | 703-474-2877
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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 | 16336
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License Number State | SC
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