Individual
DIAMOND LAWRENCETHIA GAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4661 BELPAR ST NW, CANTON, OH 44718-3602
(330) 492-2600
Mailing address
4661 BELPAR ST NW, CANTON, OH 44718-3602
(330) 492-2600
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
CDCA.166453
OH
Other
Enumeration date
03/04/2019
Last updated
03/04/2019
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