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NPI Code Detail

MEDICARE: ANGEAL DAVIS

MEDICARE: ANGEAL 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
11041C0700XClinical Social WorkerLCSW23389AZ

General Provider Information

NPI Number : 1922963180
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANGEAL DAVIS
Provider Business Mailing Address
First Line : 3450 N 3RD ST
Second Line :
City : PHOENIX
State : AZ
Zip : 85012-2331
Country : US
Telephone Number : 602-351-6986
Fax Number :
Provider Business Practice Location Address
First Line : 4420 S 32ND ST
Second Line :
City : PHOENIX
State : AZ
Zip : 85040-2804
Country : US
Telephone Number : 602-268-8748
Fax Number : 602-253-1557
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/19/2025
Last Update Date : 12/19/2025

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Directions to “ ANGEAL DAVIS ” Practice Location

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