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Individual

DR. BILLIE JO DAVIS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PH.D., BCBA

Contact information

Practice address
21 IRONWOOD DR., SUITE D PMD 106, COEUR D ALENE, ID 83815
(208) 699-2595
Mailing address
212 IRONWOOD DR. SUITE D, PMD 106, COEUR D ALENE, ID 83815
(208) 699-2595

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
LH 60063071
WA
103K00000X
Behavior Analyst
1000013
FL

Other

Enumeration date
01/08/2009
Last updated
01/08/2009
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