Provider Demographics
NPI:1730237934
Name:DAVIS, PAMELA JO (MFT)
Entity type:Individual
Prefix:
First Name:PAMELA
Middle Name:JO
Last Name:DAVIS
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1507 NW 22ND LN
Mailing Address - Street 2:
Mailing Address - City:ANKENY
Mailing Address - State:IA
Mailing Address - Zip Code:50023-0007
Mailing Address - Country:US
Mailing Address - Phone:515-418-4582
Mailing Address - Fax:
Practice Address - Street 1:1507 NW 22ND LN
Practice Address - Street 2:
Practice Address - City:ANKENY
Practice Address - State:IA
Practice Address - Zip Code:50023-0007
Practice Address - Country:US
Practice Address - Phone:515-418-4582
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-06
Last Update Date:2025-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA39927106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist