Individual
MARY A DAVIS
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
1221 W HAYS ST, BOISE, ID 83702-5316
(208) 345-7358
(208) 336-9984
Mailing address
1221 W HAYS ST, BOISE, ID 83702-5316
(208) 345-7358
(208) 336-9984
Taxonomy
Speciality
Code
Description
License number
State
103TC1900X
Counseling Psychologist
Primary
PSY-275
ID
Other
Enumeration date
06/08/2006
Last updated
07/08/2007
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