Individual provider · NPI-1

Gladys Kyrima Davis

Community/Behavioral Health · Loganville, GA

NPI number1821592478

StatusActive

Last updated in NPPESDec 4, 2019

Details

NPI: 1821592478
Entity type: Individual (NPI-1)
Name: Ms. Gladys Kyrima Davis
Sex: Female
Sole proprietor: Yes
Enumeration date: Mar 20, 2018
Last updated: Dec 4, 2019

Taxonomy and licenses

Taxonomy code	Description	License	State	Primary
251S00000X	Community/Behavioral Health	–	–	Yes
372600000X	Adult Companion	–	–
373H00000X	Day Training/Habilitation Specialist	–	–
374U00000X	Home Health Aide	–	–
376K00000X	Nurse's Aide	–	–
385H00000X	Respite Care	–	–
385HR2060X	Respite Care, Respite Care, Intellectual and/or Developmental Disabilities, Child	–	–
172V00000X	Community Health Worker	–	–
251E00000X	Home Health	–	–

Other names

Kyrima Anderson (Other Name)

Practice location

1392 Preserve Park Dr
Loganville, GA 30052-5828

Phone 404-992-7747

Mailing address

910 Athens Hwy Ste K312
Loganville, GA 30052-4952

Phone 678-697-1567

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