Davis, Kathryn Ellen

Davis, Kathryn Ellen is an individual health care provider with primary practice located at 3111 Williamson County Pkwy , Marion IL 62959-5235. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as her primary health care specialty. Davis, Kathryn Ellen can be contacted via phone (618) 997-3647.

Contact Information

Primary practice address
3111 Williamson County Pkwy Marion IL 62959-5235
Phone: (618) 997-3647
Fax: (618) 969-9437
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 1041C0700X 149.013758 Illinois

Profile Details

NPI number 1578740510
LBN Legal business name Davis, Kathryn Ellen
Credentials Licensed Clinical Social Worker (LCSW)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 22nd, 2008
Last updated Aug 20th, 2009 - about 16 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 1578740510 NPPES
Illinois Other 149.013758 ILLINOIS LICENSE

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