Individual
KEITH JAMES DAVIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LPC
Contact information
Practice address
805 N MAIN ST STE 109, MOSCOW, ID 83843-8513
(208) 831-7094
(208) 418-9816
Mailing address
707 BENTZ ST # 252, TROY, ID 83871-0015
(509) 592-0902
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
9827
ID
Other
Enumeration date
08/29/2023
Last updated
05/10/2024
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