Healthcare Provider Details

I. General information

NPI: 1659288504
Provider Name (Legal Business Name): THE PROGRESS LAB LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/26/2026
Last Update Date: 09/01/2026
Certification Date: 09/01/2026
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: 678-852-1157
  • Fax:
Mailing address:
  • Phone: 678-852-1157
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State

VIII. Authorized Official

Name: HARMONY MARIETTA DAVIDSON
Title or Position: OWNER, CLINICAL DIRECTOR
Credential: BCBA, QBA
Phone: 678-852-1157