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General NPI Number Information
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NPI Number | 1669574737
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Entity Type | Individual
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Provider Name | IVA K DAVIS MSW, ACSW
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Gender | Female
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Dates
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Enumeration Date | 09/01/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 2400 HOSPITAL RD
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City | TUSKEGEE
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State | AL
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Zip | 36083-5001
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Country | US
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Telephone | 334-727-0550
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Fax | 334-725-2776
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Provider Business Mailing Address
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Address Line | 3453 S WATER MILL RD
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City | MONTGOMERY
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State | AL
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Zip | 36116-1910
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Country | US
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Telephone | 334-277-2717
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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 | 104100000X
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Taxonomy Name | Social Worker
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License Number |
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License Number State |
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