| Provider / Organization | NPI | Date Certified |
|---|---|---|
| PENNY DAVIDSON | 1558050351 | 2023-05-06 |
Penny Davidson is registered with the National Plan and Provider Enumeration System and has been issued an National Provider Identifier (NPI) of 1558050351. Registration indicates Penny Davidson is a provider of services with a specialization in Other Service Providers, Case Manager/Care Coordinator (Case Manager/Care Coordinator, ) (All Other Specialties & Provider Types, ) (Case Manager/Care Coordinator, Other Service Providers)
| Entity Type | Individual |
| Provider Name | Penny Davidson CCSS |
| Practice Office Address | 614 BECKER AVE BELEN, NM US |
| Practice Office Telephone | 5758354357 |
| Practice Office Fax | 5055140732 |
| Mailing Address | PO BOX 456 BELEN, NM 870020456 US |
| Business Telephone | 5758354357 |
| Code | Practice | License No State |
|---|---|---|
| 171M00000X PRIMARY | Other Service Providers Case Manager/Care Coordinator Case Manager/Care Coordinator All Other Specialties & Provider Types Case Manager/Care Coordinator Other Service Providers |