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General NPI Number Information
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NPI Number | 1891022083
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Entity Type | Individual
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Provider Name | ANNIE GAY LPC
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Gender | Female
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Dates
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Enumeration Date | 11/09/2009
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Last Update Date | 11/09/2009
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Provider Practice Location Address
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Address Line | 4641 FULTON DR NW
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City | CANTON
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State | OH
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Zip | 44718-2384
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Country | US
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Telephone | 800-480-5161
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Fax |
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Provider Business Mailing Address
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Address Line | 303 E VISTA AVE
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City | AKRON
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State | OH
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Zip | 44319-3235
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Country | US
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Telephone | 330-608-6986
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | C0700154
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License Number State | OH
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