| Doctor Name: | JULIE DAVIS |
| NPI Number: | 1336478254 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | |
| License Number: | 622 |
| Business Practice Address: | 46 Iron Horse Dr Alpine, WY - 831288101 |
| Business Phone Number: | 3074132457 |
| Business Fax Number: | |
| Mailing Address: | Po Box 6956, JACKSON |
| State: | WY |
| Postal Code: | 830026956 |
| Phone Number: | 3074132457 |
| Fax Number: | |
| NPI Enumeration Date: | 12/24/2009 |
| NPI Last Update Date: | 05/06/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YA0400X |
| License Number: | 622 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | WY |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Addiction (Substance Use Disorder) |
| Taxonomy Definition: | |