ETHAN DAVIS

ROSEVILLE, CA
NPI1023462728
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy1041C0700X Social Worker, Clinical
(Licence: CA  102727)
Additional Taxonomies101YM0800X Counselor, Mental Health
Enumeration Date2016-04-19
Last Update Date2021-11-23
Business Address
ETHAN DAVIS LCSW
300 HARDING BLVD STE 108
ROSEVILLE, CA 95678-2471
Phone number: 916-741-0884
Mailing Address
ETHAN DAVIS LCSW
PO BOX 2201
ROCKLIN, CA 95677-8201
Phone number: 916-220-6784