Individual
LYNNE GRACE DAVIDSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA, LPC
Contact information
Practice address
1051 KINGSHIGHWAY ST, ROLLA, MO 65401-2938
(573) 364-8511
Mailing address
1051 KINGSHIGHWAY ST, ROLLA, MO 65401-2938
(573) 364-8511
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
2006035744
MO
Other
Enumeration date
11/13/2007
Last updated
10/02/2012
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