Individual
MR. JARED MYLES DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LPC/MHSP, NCC
Contact information
Practice address
661 MADISON AVE, MEMPHIS, TN 38103-3307
(901) 267-4008
Mailing address
661 MADISON AVE, MEMPHIS, TN 38103-3307
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
4642
TN
101YP2500X
Professional Counselor
4642
TN
Other
Enumeration date
07/26/2019
Last updated
10/15/2019
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