Provider Demographics
NPI:1407892227
Name:DAVIS, MARY STRICKLAND (PHD, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:MARY
Middle Name:STRICKLAND
Last Name:DAVIS
Suffix:
Gender:F
Credentials:PHD, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:715 9TH ST
Mailing Address - Street 2:LEXINGTON COUNTY SCHOOL DISTRICT TWO SPECIAL SERVICES
Mailing Address - City:WEST COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29169-7169
Mailing Address - Country:US
Mailing Address - Phone:803-796-4708
Mailing Address - Fax:803-739-4063
Practice Address - Street 1:715 9TH ST
Practice Address - Street 2:LEXINGTON COUNTY SCHOOL DISTRICT TWO SPECIAL SERVICES
Practice Address - City:WEST COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29169-7169
Practice Address - Country:US
Practice Address - Phone:803-796-4708
Practice Address - Fax:803-739-4063
Is Sole Proprietor?:No
Enumeration Date:2006-06-21
Last Update Date:2013-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC2388235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist