Healthcare Provider Details

I. General information

NPI: 1619750734
Provider Name (Legal Business Name): HARMONY DAVIDSON
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/14/2023
Last Update Date: 09/02/2026
Certification Date: 09/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

303 LISMORE ST
SANFORD NC
27330
US

IV. Provider business mailing address

303 LISMORE ST
SANFORD NC
27330
US

V. Phone/Fax

Practice location:
  • Phone: 743-220-8101
  • Fax:
Mailing address:
  • Phone: 743-220-8101
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number3351
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: