Individual
JASON DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
L.P.C.C.
Contact information
Practice address
801 E WASHINGTON ST, MEDINA, OH 44256-3335
(330) 722-1069
(330) 764-9712
Mailing address
801 E WASHINGTON ST, MEDINA, OH 44256-3335
(330) 722-1069
(330) 764-9712
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
C.1500589
OH
101YP2500X
Professional Counselor
Primary
E.1901564
OH
Other
Enumeration date
02/10/2017
Last updated
12/16/2019
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