Provider Demographics
NPI:1346599370
Name:DAVIS, CHEZLIE NICOLE (MS, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:CHEZLIE
Middle Name:NICOLE
Last Name:DAVIS
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9040 EXECUTIVE PARK DR STE 105
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37923-4630
Mailing Address - Country:US
Mailing Address - Phone:865-803-7633
Mailing Address - Fax:865-769-0801
Practice Address - Street 1:9040 EXECUTIVE PARK DR STE 105
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37923-4630
Practice Address - Country:US
Practice Address - Phone:865-803-7633
Practice Address - Fax:865-769-0801
Is Sole Proprietor?:No
Enumeration Date:2012-09-05
Last Update Date:2012-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN4552235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist