Davis, Stellanda M

Davis, Stellanda M is an individual health care provider with primary practice located at 17280 Highway 17 South , Lexington MS 39095-0479. She recently has only one registered license in Behavioral Health & Social Service Providers / Marriage & Family Therapist, which is considered as her primary health care specialty. Davis, Stellanda M can be contacted via phone (662) 834-1857.

Contact Information

Primary practice address
17280 Highway 17 South Lexington MS 39095-0479
Phone: (662) 834-1857
Fax: (662) 834-4937
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Marriage & Family Therapist 106H00000X M4543 Mississippi

Profile Details

NPI number 1336358951
LBN Legal business name Davis, Stellanda M
Credentials LMSW, MFT
Entity Individual
Sole proprietor 1 No
Enumeration date May 21st, 2007
Last updated Jul 8th, 2007 - about 19 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 1336358951 NPPES
Mississippi Other T0261 MASTER LICENSE SOCIAL WOR
Mississippi Other M4543 MASTER LICENSE SOCIAL WOR

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