MEDICARE: MS. REBECCA REESE 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
1	1041C0700X	Clinical Social Worker	CSWS749	AK

General Provider Information

NPI Number	:	1548349111
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. REBECCA REESE DAVIS LCSW

Provider Business Mailing Address
First Line	:	2600 CORDOVA ST STE 101
Second Line	:
City	:	ANCHORAGE
State	:	AK
Zip	:	99503-2745
Country	:	US
Telephone Number	:	907-279-9640
Fax Number	:

Provider Business Practice Location Address
First Line	:	2600 CORDOVA ST STE 101
Second Line	:
City	:	ANCHORAGE
State	:	AK
Zip	:	99503-2745
Country	:	US
Telephone Number	:	907-279-9640
Fax Number	:

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

Provider Enumeration Date	:	11/03/2006
Last Update Date	:	07/19/2021

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