| 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) |
| Enumeration Date | 2017-10-30 |
| Last Update Date | 2022-04-21 |