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NPI Code Detail

MEDICARE: HOLLY NICOLE DAVIS LCSW

MEDICARE: HOLLY NICOLE DAVIS LCSW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11041C0700XClinical Social Worker6191LA

General Provider Information

NPI Number : 1215097225
Entity Type Code : Individual
Provider Name (Legal Business Name) : HOLLY NICOLE DAVIS LCSW
Provider Business Mailing Address
First Line : 4615 GOVERNMENT ST BLDG 2
Second Line :
City : BATON ROUGE
State : LA
Zip : 70806-5820
Country : US
Telephone Number : 225-922-0445
Fax Number : 225-922-0771
Provider Business Practice Location Address
First Line : 4615 GOVERNMENT ST BLDG 2
Second Line :
City : BATON ROUGE
State : LA
Zip : 70806-5820
Country : US
Telephone Number : 225-922-0445
Fax Number : 225-922-0771
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/11/2006
Last Update Date : 07/08/2007

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Directions to “ HOLLY NICOLE DAVIS LCSW” Practice Location

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