Organization
JENNIFER DAVIS AND MICHELLE S. WHITE
Active
Other names
Family Adolescent Child Treatment Service, LLC
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JENNIFER N DAVIS PSY.D. (LICENSED CLINICAL PSYCHOLOGIST)
(773) 282-2322
Entity
Organization
Contact information
Practice address
4801 W PETERSON AVE STE 401, CHICAGO, IL 60646-5730
(773) 282-2322
(773) 282-2853
Mailing address
4801 W PETERSON AVE STE 401, CHICAGO, IL 60646-5730
(773) 282-2322
(773) 282-2853
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
—
—
Other
Enumeration date
12/18/2020
Last updated
12/21/2020
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