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Individual
IRA ROBERT DAVIS JR.
Active
Individual
IRA ROBERT DAVIS JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CO60937157
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
CO60937157
WA
Other
Enumeration date
01/07/2020
Last updated
01/07/2020
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