| NPI | 1326535766 |
|---|---|
| Former Name | LEAH MARISSA DAVIS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OH CDCA.165558) |
| Enumeration Date | 2018-04-20 |
| Last Update Date | 2024-09-16 |