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General NPI Number Information
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NPI Number | 1528743622
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Entity Type | Individual
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Provider Name | JENNIFER CHRISTINE DAVIS LCDC, LPC-A
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Gender | Female
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Dates
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Enumeration Date | 06/16/2023
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Last Update Date | 06/16/2023
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Provider Practice Location Address
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Address Line | 4516 BOAT CLUB RD STE 106
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City | FORT WORTH
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State | TX
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Zip | 76135-7020
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Country | US
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Telephone | 817-238-7473
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Fax |
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Provider Business Mailing Address
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Address Line | 7902 FOX CHASE DR
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City | ARLINGTON
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State | TX
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Zip | 76001-2909
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Country | US
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Telephone | 469-865-0469
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 87888
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License Number State | TX
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