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1134904949
KEITH JAMES DAVIS
MOSCOW, ID
NPI
1134904949
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
101YP2500X Counselor, Professional
(Licence: ID 9827)
Enumeration Date
2023-08-29
Last Update Date
2024-05-10
Business Address
KEITH JAMES DAVIS LPC
805 N MAIN ST STE 109
MOSCOW, ID 83843-8513
Phone number: 208-831-7094
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Mailing Address
KEITH JAMES DAVIS LPC
707 BENTZ ST # 252
TROY, ID 83871-0015
Phone number: 509-592-0902
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