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1790309003
GARY RALPH DAVIS
BEREA, KY
NPI
1790309003
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
1041C0700X Social Worker, Clinical
(Licence: KY 447)
Enumeration Date
2020-06-02
Last Update Date
2020-06-02
Business Address
GARY RALPH DAVIS LCSW
275 PINE VALLEY RD
BEREA, KY 40403-9544
Phone number: 859-302-7504
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Mailing Address
GARY RALPH DAVIS LCSW
275 PINE VALLEY RD
BEREA, KY 40403-9544
Phone number: 859-302-7504
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