Individual
MS. JACQUELINE DAVIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCPC, LMHC
Contact information
Practice address
7403 CLINE AVE, SCHERERVILLE, IN 46375-2645
(219) 322-8614
(219) 322-8502
Mailing address
7403 CLINE AVE, SCHERERVILLE, IN 46375-2645
(219) 322-8614
(219) 322-8502
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
180.006831
IL
101YM0800X
Mental Health Counselor
Primary
39002046A
IN
Other
Enumeration date
03/29/2010
Last updated
03/29/2010
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