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NPI Code Detail

MEDICARE: AMANDA CLAIRE DAVIS M.A., BCBA, LBA

MEDICARE: AMANDA CLAIRE DAVIS M.A., BCBA, LBA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103K00000XBehavior Analyst5284TX

General Provider Information

NPI Number : 1427778141
Entity Type Code : Individual
Provider Name (Legal Business Name) : AMANDA CLAIRE DAVIS M.A., BCBA, LBA
Provider Business Mailing Address
First Line : 1250 HILLRISE CIR
Second Line :
City : LAS CRUCES
State : NM
Zip : 88011-4741
Country : US
Telephone Number : 720-966-8200
Fax Number :
Provider Business Practice Location Address
First Line : 1250 HILLRISE CIR
Second Line :
City : LAS CRUCES
State : NM
Zip : 88011-4741
Country : US
Telephone Number : 720-966-8200
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/01/2022
Last Update Date : 05/11/2026

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