MEDICARE: MS. PATRICIA DAVIS M.S. CCC-SLP

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
1	235Z00000X	Speech-Language Pathologist	9225	NC

General Provider Information

NPI Number	:	1518277318
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. PATRICIA DAVIS M.S. CCC-SLP

Provider Business Mailing Address
First Line	:	4121 LITTLE SAVANNAH RD
Second Line	:	RM 132
City	:	CULLOWHEE
State	:	NC
Zip	:	28723-9646
Country	:	US
Telephone Number	:	828-227-7251
Fax Number	:	828-227-3312

Provider Business Practice Location Address
First Line	:	4121 LITTLE SAVANNAH RD
Second Line	:	RM 132
City	:	CULLOWHEE
State	:	NC
Zip	:	28723-9646
Country	:	US
Telephone Number	:	828-227-7251
Fax Number	:	828-227-3312

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/14/2010
Last Update Date	:	09/26/2014

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