Individual
CRYSTAL DOMINIQUE MOORE-DAVIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1400 E 55TH ST, CLEVELAND, OH 44103-1304
(216) 391-6672
Mailing address
1400 E 55TH ST, CLEVELAND, OH 44103-1304
(216) 391-6672
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
187358
OH
Other
Enumeration date
12/19/2024
Last updated
12/19/2024
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