Individual
TREVER D DAVIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DBH, LAC
Contact information
Practice address
771 ALFONSE RD, CLARKDALE, AZ 86324-7402
(928) 458-6198
Mailing address
771 ALFONSE RD, CLARKDALE, AZ 86324-7402
(928) 458-6198
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
LAC-13121
AZ
101YA0400X
Addiction (Substance Use Disorder) Counselor
LAC-13121
AZ
101YM0800X
Mental Health Counselor
LAC-13121
AZ
Other
Enumeration date
09/20/2017
Last updated
07/21/2022
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