| NPI | 1821615832 |
|---|---|
| Former Name | CYNTHIA MACHELLE DAVIS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: 17-p-11) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: OR 1-qmha-1-00261) |
| Enumeration Date | 2020-06-25 |
| Last Update Date | 2020-06-25 |