Healthcare Provider Details

I. General information

NPI: 1134809544
Provider Name (Legal Business Name): LEAVES OF THE TREE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/20/2023
Last Update Date: 05/23/2024
Certification Date: 05/23/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4275 FULTON DR NW
CANTON OH
44718-2821
US

IV. Provider business mailing address

3181 ANGLETERRE BLVD
AKRON OH
44312-5005
US

V. Phone/Fax

Practice location:
  • Phone: 330-249-3004
  • Fax:
Mailing address:
  • Phone: 330-265-8915
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code221700000X
TaxonomyArt Therapist
License Number
License Number State

VIII. Authorized Official

Name: ADRIANNE N SNYDER
Title or Position: ART THERAPIST, COUNSELOR, OWNER
Credential: MA, ATR-BC, LPCC
Phone: 330-249-3004