Individual
ELIZABETH ANN DOUCE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
INDEPENDENT PROVIDER
Contact information
Practice address
6648 MARELIS AVE NE, CANTON, OH 44721-2469
(330) 418-3392
(330) 494-3337
Mailing address
6648 MARELIS AVE NE, CANTON, OH 44721-2469
(330) 418-3392
(330) 494-3337
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
103315602599
—
OH
Enumeration date
02/25/2021
Last updated
02/25/2021
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