Individual
MR. JOHN DAVIS III
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMSW
Contact information
Practice address
1720 N WESTGATE DR STE A-1, BOISE, ID 83704-7164
(208) 334-0874
(208) 334-0812
Mailing address
1720 N WESTGATE DR STE A-1, BOISE, ID 83704-7164
(208) 334-0874
(208) 334-0812
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
LMSW-35378
ID
Other
Enumeration date
03/14/2019
Last updated
03/14/2019
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