Individual
MR. JODY M. DAVIDSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
L.C.S.W.
Contact information
Practice address
1513 22ND ST, LAKE CHARLES, LA 70601-8821
(337) 794-1141
Mailing address
1513 22ND ST, LAKE CHARLES, LA 70601-8821
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
7754
LA
Other
Enumeration date
09/25/2007
Last updated
10/28/2021
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