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Individual
MS. MARIA LASALLE DAVIDSON
Active
Individual
MS. MARIA LASALLE DAVIDSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LISW-S
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
I1500352
OH
101YM0800X
Mental Health Counselor
I1500352
OH
Other
Enumeration date
04/03/2018
Last updated
06/26/2019
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