Individual ProviderKrystalyn T DavisSocial WorkerBehavioral Health & Social Service ProvidersPractice Address1295 N Providence Rd Apt F015r, Media, PA 19063-1234(484) 326-9733PECOS EnrollmentBased on the most recent information from CMS, provider Krystalyn T Davis does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 2 days ago.Profile DetailsProvider ID1013221043Provider TypeIndividualFull NameDavis, Krystalyn TGenderFemaleSole ProprietorYesEnumeration Date8/2/2010Last Updated8/2/2010Contact InformationPractice LocationPractice Address1295 N Providence Rd Apt F015r, Media, PA 19063-1234Phone(484) 326-9733FaxUnlisted FaxMailing LocationMailing Address1295 N Providence Rd Apt F105r, Media, PA 19063-1215PhoneUnlisted PhoneFaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode1041C0700XPrimaryDescriptionSocial WorkerBehavioral Health & Social Service ProvidersLicenseSW126557PennsylvaniaCode1041C0700XDescriptionSocial WorkerBehavioral Health & Social Service ProvidersLicense066014-1New York