Provider Demographics
NPI:1932822707
Name:DAVIS, SAVANNA THOMPSON
Entity Type:Individual
Prefix:
First Name:SAVANNA
Middle Name:THOMPSON
Last Name:DAVIS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:108 POTANO DR
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:SC
Mailing Address - Zip Code:29072-7138
Mailing Address - Country:US
Mailing Address - Phone:803-351-8643
Mailing Address - Fax:800-711-8650
Practice Address - Street 1:259 RIVER RIDGE WAY
Practice Address - Street 2:
Practice Address - City:SWANSEA
Practice Address - State:SC
Practice Address - Zip Code:29160-8287
Practice Address - Country:US
Practice Address - Phone:803-351-8643
Practice Address - Fax:800-711-8650
Is Sole Proprietor?:Yes
Enumeration Date:2022-09-26
Last Update Date:2023-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist