Doctor Name: | DIERDRE J DAVISON |
NPI Number: | 1780866814 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LPCCS/LICD |
License Number: | S4691 |
Business Practice Address: | 624 Market Ave. N. Canton, OH - 447021017 |
Business Phone Number: | 3304934553 |
Business Fax Number: | 3304933761 |
Mailing Address: | 624 Market Ave. N, CANTON |
State: | OH |
Postal Code: | 447021017 |
Phone Number: | 3304934553 |
Fax Number: | 3304933761 |
NPI Enumeration Date: | 11/30/2007 |
NPI Last Update Date: | 04/14/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101Y00000X |
License Number: | S4691 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | OH |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | |
Taxonomy Definition: | A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master |