Individual
EDWARD DAVIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MS
Contact information
Practice address
119 W MAIN ST, EMMETT, ID 83617-2935
(986) 895-4507
(208) 277-3133
Mailing address
8401 W IDAHO BLVD, LETHA, ID 83636-7706
(986) 895-4507
(208) 277-3133
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
8331398
ID
101YP2500X
Professional Counselor
Primary
LPC-9028
ID
101YP2500X
Professional Counselor
PC019860
PA
Other
Enumeration date
07/29/2022
Last updated
02/10/2026
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