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Individual

DANIEL DAVIS JR.

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
104 BIG BEND RANCH ROAD, WADSWORTH, NV 89442-9442
(775) 352-6849
(775) 575-3180
Mailing address
104 BIG BEND RANCH ROAD, WADSWORTH, NV 89442-9442
(775) 352-6849
(775) 575-3180

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
004701001
NV
Enumeration date
04/11/2008
Last updated
05/02/2012
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