Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 103K00000X | Behavior Analyst | BACB449636 | GA |
Y | 106E00000X | Assistant Behavior Analyst | 0-21-12051 | GA |
NPI | 1164006490 |
---|---|
Provider Name | Dr. Doris Michelle Davis |
First Address | Stuart, FL 34997-7462 |
Second Address | Savannah, GA 31401-3378 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/05/2021 |
Last Update Date | 21/05/2021 |