Healthcare Provider Details

I. General information

NPI: 1326400359
Provider Name (Legal Business Name): ERICKA JEANICE LAWTON DAVIS BCABA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/29/2016
Last Update Date: 06/14/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6050 SCOTCHWOOD GLEN, UNIT 106
ORLANDO FL
32822-4333
US

IV. Provider business mailing address

6050 SCOTCHWOOD GLEN, UNIT 106
ORLANDO FL
32822-4333
US

V. Phone/Fax

Practice location:
  • Phone: 941-447-3745
  • Fax:
Mailing address:
  • Phone: 941-447-3745
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106E00000X
TaxonomyAssistant Behavior Analyst
License Number0-17-7709
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: