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1407335011
LAKEESHA M WISE
CANTON, OH
NPI
1407335011
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: OH CDCA.164627)
Enumeration Date
2018-08-14
Last Update Date
2018-08-14
Business Address
LAKEESHA M WISE
1930 FULTON RD NW STE 103
CANTON, OH 44709-3526
Phone number: 330-956-5936
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Mailing Address
LAKEESHA M WISE
1930 FULTON RD NW STE 103
CANTON, OH 44709-3526
Phone number: 330-956-5936
Copy
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