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NPI Code Detail

MEDICARE: CHANITA DAVIS

MEDICARE: CHANITA DAVIS
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
1106S00000XBehavior Technician

General Provider Information

NPI Number : 1841062171
Entity Type Code : Individual
Provider Name (Legal Business Name) : CHANITA DAVIS
Provider Business Mailing Address
First Line : PO BOX 360595
Second Line :
City : PITTSBURGH
State : PA
Zip : 15251-6595
Country : US
Telephone Number : 718-215-5311
Fax Number :
Provider Business Practice Location Address
First Line : 2751 WARM SPRINGS RD STE A
Second Line :
City : COLUMBUS
State : GA
Zip : 31904-5327
Country : US
Telephone Number : 718-215-5311
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/30/2023
Last Update Date : 10/30/2023

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Directions to “ CHANITA DAVIS ” Practice Location

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