Individual
JONATHAN DAVID DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.A., LPC
Contact information
Practice address
1304 CHINOOK LN, PUEBLO, CO 81001-1851
(719) 545-2746
Mailing address
1012 W ABRIENDO AVE, PUEBLO, CO 81004-1128
(719) 583-2007
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
LPC.0012457
CO
Other
Enumeration date
06/10/2011
Last updated
01/14/2022
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