Individual
CASSIE DAVIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3522 BRIAR CREEK LN, AMMON, ID 83406-4728
(208) 529-1660
(208) 529-1699
Mailing address
3522 BRIAR CREEK LN, PO BOX 3858, AMMON, ID 83406-4728
(208) 529-1660
(208) 529-1699
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LMSW-32584
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
LMSW-32584
STATE LICENSE - LMSW
ID
Enumeration date
03/21/2013
Last updated
03/21/2013
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