Individual
MR. FRED G. DAVIS SR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LPC
Contact information
Practice address
431 N STATE ST, JACKSON, MS 39201-1108
(601) 949-1949
(601) 714-6922
Mailing address
1 WATERFORD PL, JACKSON, MS 39211-2900
(601) 624-2300
(601) 956-9644
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
1340
MS
Other
Enumeration date
07/17/2008
Last updated
07/17/2008
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