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AARON DAVIS LCSW

Clinical >> Social Worker >> Behavioral Health & Social Service Providers

Registrant NPI Number: 1912245408

Individual Registrant:
 AARON  DAVIS LCSW
Gender: M
Not Sole Proprietor

Location and contact information for practice:
904 E. MARTIN LUTHER KING DR.  CENTRALIA, IL 62801-3058 US
Tel: 618-533-1391  Fax: 618-533-0012

Contact information for business:
904 E. MLK DR.  CENTRALIA, IL 62801-3058 US
Tel: 618-533-1391  Fax: 618-533-0012

Registration Information:
NPI: 1912245408
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y1041C0700XBehavioral Health & Social Service Providers
Social Worker
Clinical
IL149.011054

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




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