Healthcare Provider Details

I. General information

NPI: 1811630817
Provider Name (Legal Business Name): REBECCA DAVIS RBT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/18/2022
Last Update Date: 12/12/2025
Certification Date: 12/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4180 S A ST
RICHMOND IN
47374-6055
US

IV. Provider business mailing address

211 E ORCHARD ST
WEST MANCHESTER OH
45382-5053
US

V. Phone/Fax

Practice location:
  • Phone: 317-222-1242
  • Fax:
Mailing address:
  • Phone: 270-589-9043
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: