Davis, Michelle Renee

Davis, Michelle Renee is an sole proprietor health care provider with primary practice located at 519 Newhaven St , Oak Park CA 91377-4821. She recently has only one registered license in Behavioral Health & Social Service Providers / Professional, which is considered as her primary health care specialty. Davis, Michelle Renee can be contacted via phone (216) 409-5820.

Contact Information

Primary practice address
519 Newhaven St Oak Park CA 91377-4821
Phone: (216) 409-5820
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Professional 101YP2500X E.2102428-SUPV Ohio
Behavioral Health & Social Service Providers / Professional 101YP2500X 180.015142 Illinois

Profile Details

NPI number 1154834158
LBN Legal business name Davis, Michelle Renee
Credentials LPCC-S
Entity Individual
Sole proprietor 1 Yes
Enumeration date Nov 13th, 2017
Last updated Apr 3rd, 2024 - about 7 months ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1154834158 NPPES
Ohio MEDICAID 0286648

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