Individual
MR. JEFFERSON E DAVIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LSCSW, LCSW
Contact information
Practice address
8313 N HARBOUR PL, PARKVILLE, MO 64152-4313
(816) 536-6955
Mailing address
8313 N HARBOUR PL, PARKVILLE, MO 64152-4313
(816) 536-6955
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
2000175108
MO
1041C0700X
Clinical Social Worker
2109
KS
Other
Enumeration date
08/26/2022
Last updated
08/26/2022
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