Provider Demographics
NPI:1548773724
Name:DAVIS-NELSON, TAMARA D (LSW)
Entity Type:Individual
Prefix:
First Name:TAMARA
Middle Name:D
Last Name:DAVIS-NELSON
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:TAMARA
Other - Middle Name:D
Other - Last Name:KISOR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1049 WESTERN AVE
Mailing Address - Street 2:
Mailing Address - City:CHILLICOTHE
Mailing Address - State:OH
Mailing Address - Zip Code:45601-1104
Mailing Address - Country:US
Mailing Address - Phone:740-773-4366
Mailing Address - Fax:740-775-7855
Practice Address - Street 1:90 HOSPITAL DR
Practice Address - Street 2:
Practice Address - City:ATHENS
Practice Address - State:OH
Practice Address - Zip Code:45701-2301
Practice Address - Country:US
Practice Address - Phone:740-592-3091
Practice Address - Fax:740-773-3985
Is Sole Proprietor?:No
Enumeration Date:2017-11-10
Last Update Date:2020-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker