Individual
LON 'MARK' DAVIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LPC, NCC
Contact information
Practice address
20157 SALINA RD., WAYNESVILLE, MO 65583
(573) 528-3671
(573) 774-3711
Mailing address
PO BOX 122, WAYNESVILLE, MO 65583-0122
(573) 528-3671
(573) 774-3711
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
2002020622
MO
Other
Enumeration date
11/07/2006
Last updated
07/08/2007
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