Individual
JASON THOMAS DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MA, LPC
Contact information
Practice address
2530 CRAWFORD AVE STE 208, EVANSTON, IL 60201-4959
(224) 688-2277
Mailing address
2530 CRAWFORD AVE STE 208, EVANSTON, IL 60201-4959
(224) 688-2277
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
—
IL
Other
Enumeration date
06/07/2017
Last updated
06/07/2017
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