Individual
JEANETTE J DAVIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
850 GRAND AVE, GRAND JUNCTION, CO 81501-3425
(970) 243-6377
Mailing address
3021 SEQUEL WAY, GRAND JUNCTION, CO 81504-4214
(970) 434-5373
(970) 523-4789
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LCSW992195
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
136245
—
CO
Enumeration date
12/27/2006
Last updated
07/08/2007
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