Davis, Joanna Brooke

Davis, Joanna Brooke is an individual health care provider with primary practice located at 930 N Ferdon Blvd , Crestview FL 32536-1706. 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, Joanna Brooke can be contacted via phone (850) 331-2987.

Contact Information

Primary practice address
930 N Ferdon Blvd Crestview FL 32536-1706
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Speech, Language and Hearing Service Providers / Speech-Language Pathologist 235Z00000X SA15824 Florida

Profile Details

NPI number 1376059907
LBN Legal business name Davis, Joanna Brooke
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 19th, 2017
Last updated Jul 15th, 2020 - about 5 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1376059907 NPPES
Other 1497122725 TRICARE

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