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General NPI Number Information
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NPI Number | 1922367432
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Entity Type | Individual
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Provider Name | KRISTI J DAVIDSON LCSW
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Gender | Female
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Dates
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Enumeration Date | 05/04/2012
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Last Update Date | 07/27/2023
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Provider Practice Location Address
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Address Line | 1907 JOHNSON ST
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City | JENNINGS
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State | LA
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Zip | 70546-3627
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Country | US
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Telephone | 337-785-4700
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Fax |
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Provider Business Mailing Address
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Address Line | 211 E NICHOLS ST
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City | WELSH
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State | LA
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Zip | 70591-4313
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Country | US
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Telephone | 337-275-6190
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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 | 6733
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License Number State | LA
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