Individual
TARA L DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNP, LPCC-S
Contact information
Practice address
1201 S MAIN ST STE 100, CANTON, OH 44720-4283
(330) 244-8782
(330) 244-8795
Mailing address
1201 S MAIN ST STE 100, CANTON, OH 44720-4283
(330) 244-8782
(330) 244-8795
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
E.0008189-SUPV
OH
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
APRN.CNP.023645
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0315885
—
OH
01
—
11797385
PSYCHIATRY
OH
Enumeration date
03/29/2007
Last updated
11/20/2023
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