Individual
MCKAY KNIGHT DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MACL, LPC, CRADC
Contact information
Practice address
689 W JUAN TABO LN, REPUBLIC, MO 65738-1487
(417) 838-7105
Mailing address
689 W JUAN TABO LN, REPUBLIC, MO 65738-1487
(417) 838-7105
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
8056
MO
101YP2500X
Professional Counselor
Primary
2013022743
MO
Other
Enumeration date
09/03/2013
Last updated
06/07/2015
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