Healthcare Provider Details

I. General information

NPI: 1235053968
Provider Name (Legal Business Name): KINLEY LAYNE DAVIS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/06/2026
Last Update Date: 08/06/2026
Certification Date: 08/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1022 JONES RD
SPRINGDALE AR
72762-0705
US

IV. Provider business mailing address

278 N WILD GOOSE AVE UNIT 2
FARMINGTON AR
72730-3188
US

V. Phone/Fax

Practice location:
  • Phone: 479-318-2300
  • Fax:
Mailing address:
  • Phone: 870-679-9940
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: