Davis, Jacqueline D
Davis, Jacqueline D is an sole proprietor health care provider with primary practice located at 134 Woodcrest Cir , Warner Robins GA 31093-3034. She recently has only one registered license in Speech, Language and Hearing Service Providers / Speech-Language Pathologist, which is considered as her primary health care specialty. Davis, Jacqueline D can be contacted via phone (478) 929-0513.Contact Information
Primary practice address
134 Woodcrest Cir
Warner Robins GA 31093-3034
Phone: (478) 929-0513
Fax: (478) 929-0513
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Speech, Language and Hearing Service Providers / Speech-Language Pathologist | 235Z00000X | SLP001725 | Georgia |
Profile Details
| NPI number | 1083750178 |
|---|---|
| LBN Legal business name | Davis, Jacqueline D |
| Credentials | M.ED. CCCSLP |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jan 29th, 2007 |
| Last updated | Jul 9th, 2007 - about 18 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1083750178 | NPPES |
| Georgia | MEDICAID | 00661746C |
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