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Individual

DR. JIMMY DAVIS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
LCDC, LCPC, CFC

Contact information

Practice address
367 WATERFRONT ROW, QUITMAN, TX 75783-3558
(214) 463-8142
Mailing address
367 WATERFRONT ROW, QUITMAN, TX 75783-3558
(214) 463-8142

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
6594
TX
101YP1600X
Pastoral Counselor
7347688
PA

Other

Enumeration date
12/01/2015
Last updated
07/18/2016
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