Crystal A Davis, LPC
Counselor in Moscow, ID. Individual provider (NPI-1).
NPI number1871279331
StatusActive
Last updated in NPPESJun 27, 2023
Details
- NPI
- 1871279331
- Entity type
- Individual (NPI-1)
- Name
- Crystal A Davis
- Credential
- LPC
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Jun 27, 2023
- Certification date
- Jun 27, 2023
- Last updated
- Jun 27, 2023
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 101Y00000X | Counselor | 9599 | ID | Yes |
Practice location
818 S Washington StMoscow, ID 83843-3049
Phone 208-882-8514
Mailing address
818 S Washington StMoscow, ID 83843-3049
Phone 208-882-8514
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