Provider Demographics
NPI:1891953733
Name:DAVIS, KIM-OANH H (MASTERS DEGREE)
Entity Type:Individual
Prefix:MRS
First Name:KIM-OANH
Middle Name:H
Last Name:DAVIS
Suffix:
Gender:F
Credentials:MASTERS DEGREE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:119 SPRINGHALL DR
Mailing Address - Street 2:SUITE C
Mailing Address - City:GOOSE CREEK
Mailing Address - State:SC
Mailing Address - Zip Code:29445-5368
Mailing Address - Country:US
Mailing Address - Phone:843-329-0785
Mailing Address - Fax:843-329-0790
Practice Address - Street 1:119 SPRINGHALL DR
Practice Address - Street 2:SUITE C
Practice Address - City:GOOSE CREEK
Practice Address - State:SC
Practice Address - Zip Code:29445-5368
Practice Address - Country:US
Practice Address - Phone:843-329-0785
Practice Address - Fax:843-329-0790
Is Sole Proprietor?:No
Enumeration Date:2008-05-28
Last Update Date:2010-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC2228231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist