Individual
AARON DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
904 E. MARTIN LUTHER KING DR., CENTRALIA, IL 62801-3058
(618) 533-1391
(618) 533-0012
Mailing address
904 E. MLK DR., CENTRALIA, IL 62801-3058
(618) 533-1391
(618) 533-0012
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
149.011054
IL
Other
Enumeration date
01/18/2013
Last updated
01/18/2013
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