Individual
KATHRYN DAVIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2267 TETON PLZ, IDAHO FALLS, ID 83404-6486
(208) 522-0140
(208) 524-7335
Mailing address
5408 BARTON LN, AMMON, ID 83406-5044
(208) 569-1883
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
LPC-8928
ID
Other
Enumeration date
07/12/2022
Last updated
07/12/2022
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