Individual
MS. JACQUI DAVIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.S. PSYCHOLOGY, LPC
Contact information
Practice address
1215 SW G ST, GRANTS PASS, OR 97526-2544
(541) 472-5845
(541) 476-1526
Mailing address
1630 WILLIAMS HWY, GRANTS PASS, OR 97527-5660
(541) 660-0436
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
C2052
OR
Other
Enumeration date
09/30/2008
Last updated
09/30/2008
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