MEDICARE: MRS. JANICE R. 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	SP7144	OH

General Provider Information

NPI Number	:	1881095404
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. JANICE R. DAVIS M.S., CCC-SLP

Provider Business Mailing Address
First Line	:	5975 LIBERTY FAIRFIELD RD
Second Line	:
City	:	LIBERTY TWP
State	:	OH
Zip	:	45011-2281
Country	:	US
Telephone Number	:	513-304-0119
Fax Number	:

Provider Business Practice Location Address
First Line	:	5975 LIBERTY FAIRFIELD RD
Second Line	:
City	:	LIBERTY TWP
State	:	OH
Zip	:	45011-2281
Country	:	US
Telephone Number	:	513-304-0119
Fax Number	:

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

Provider Enumeration Date	:	09/15/2014
Last Update Date	:	09/15/2014

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Directions to “ MRS. JANICE R. DAVIS M.S., CCC-SLP” Practice Location

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