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1104301977
IAN WILLIAM DAVIS
GRASS VALLEY, CA
NPI
1104301977
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
101YM0800X Counselor, Mental Health
Enumeration Date
2018-09-27
Last Update Date
2018-09-27
Business Address
IAN WILLIAM DAVIS
714 W MAIN ST
GRASS VALLEY, CA 95945-6410
Phone number: 530-477-9800
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Mailing Address
IAN WILLIAM DAVIS
714 W MAIN ST
GRASS VALLEY, CA 95945-6410
Phone number: 530-477-9800
Copy
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