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Individual

CRYSTAL A DAVIS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LPC

Contact information

Practice address
818 S WASHINGTON ST, MOSCOW, ID 83843-3049
(208) 882-8514
Mailing address
818 S WASHINGTON ST, MOSCOW, ID 83843-3049
(208) 882-8514

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
9599
ID

Other

Enumeration date
06/27/2023
Last updated
06/27/2023
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