Individual
JO DAVIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LISW
Contact information
Practice address
1001 W BROADWAY, STE. C, FARMINGTON, NM 87401-5638
(505) 326-4383
(505) 325-1925
Mailing address
PO BOX 2856, FARMINGTON, NM 87499-2856
(505) 860-2689
(505) 327-0132
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
I-05901
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
74559079
—
NM
Enumeration date
08/15/2006
Last updated
07/09/2007
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