NPI | 1235641390 |
---|---|
Former Name | ANGELA DAWN DAVIS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OH 141153) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: OH S.2504119-TRNE) |
Enumeration Date | 2017-10-30 |
Last Update Date | 2025-05-13 |