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NPI Code Detail

MEDICARE: MALLORIE DAVIS

MEDICARE:   MALLORIE  DAVIS
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
1101YM0800XMental Health Counselor9943LA

General Provider Information

NPI Number : 1598697286
Entity Type Code : Individual
Provider Name (Legal Business Name) : MALLORIE DAVIS
Provider Business Mailing Address
First Line : 18069 HOLLY RIDGE DR
Second Line :
City : HAMMOND
State : LA
Zip : 70403-0233
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 4955 W NAPOLEON AVE # 3013
Second Line :
City : METAIRIE
State : LA
Zip : 70001-2249
Country : US
Telephone Number : 986-778-1823
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/29/2026
Last Update Date : 05/29/2026

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Directions to “ MALLORIE DAVIS ” Practice Location

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