Individual
MICHELLE RENEE DAVIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPCC-S
Contact information
Practice address
519 NEWHAVEN ST, OAK PARK, CA 91377-4821
(216) 409-5820
Mailing address
37303 HARVEST AVE, AVON, OH 44011-2803
(440) 847-8505
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
180.015142
IL
101YP2500X
Professional Counselor
Primary
E.2102428-SUPV
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0286648
—
OH
Enumeration date
11/13/2017
Last updated
04/03/2024
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