| NPI | 1124836333 |
|---|---|
| Other Name | CRYSTAL DOMINIQUE DAVIS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OH 187358) |
| Enumeration Date | 2024-12-19 |
| Last Update Date | 2024-12-19 |