Provider Demographics
NPI:1457979965
Name:DAVIS, FRANK SCOTT (SLP)
Entity Type:Individual
Prefix:MR
First Name:FRANK
Middle Name:SCOTT
Last Name:DAVIS
Suffix:
Gender:M
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2090 W FIRST ST APT 2309
Mailing Address - Street 2:
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33901-3123
Mailing Address - Country:US
Mailing Address - Phone:248-224-2791
Mailing Address - Fax:
Practice Address - Street 1:2090 W FIRST ST APT 2309
Practice Address - Street 2:
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33901-3123
Practice Address - Country:US
Practice Address - Phone:248-224-2791
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-07-10
Last Update Date:2020-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI7101000117235Z00000X
FLSA12193235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist