Davis, Tara L

Davis, Tara L is an individual health care provider with primary practice located at 1201 S Main St Ste 100 , Canton OH 44720-4283. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Professional, Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health. Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health is her primary health care specialty. Davis, Tara L can be contacted via phone (330) 244-8782.

Contact Information

Primary practice address
1201 S Main St Ste 100 Canton OH 44720-4283
Phone: (330) 244-8782
Fax: (330) 244-8795
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Professional 101YP2500X E.0008189-SUPV Ohio
Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health 363LP0808X APRN.CNP.023645 Ohio

Profile Details

NPI number 1821118530
LBN Legal business name Davis, Tara L
Credentials CNP, LPCC-S
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 29th, 2007
Last updated Nov 20th, 2023 - about last year

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 1821118530 NPPES
Ohio MEDICAID 0315885
Ohio Other 11797385

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