| NPI | 1124387329 |
|---|---|
| Former Name | ASHLEY JESSICA DAVIS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: OK 6314) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health |
| 101YA0400X Counselor Addiction (Substance Use Disorder) | |
| Enumeration Date | 2012-05-08 |
| Last Update Date | 2019-03-29 |