Individual
JENIKA DAVIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
1919 W STATE ST, BOISE, ID 83702-3958
(208) 813-6246
Mailing address
1919 W STATE ST, BOISE, ID 83702-3958
(208) 813-6246
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
LPC-7415
ID
101YP2500X
Professional Counselor
Primary
LPC-7415
ID
Other
Enumeration date
08/23/2019
Last updated
08/23/2019
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