Healthcare Provider Details

I. General information

NPI: 1639085319
Provider Name (Legal Business Name): NEPHITERIA ALISHA DAVIS BCBA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/21/2026
Last Update Date: 08/21/2026
Certification Date: 08/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

560 TRINITY CREEK CV
CORDOVA TN
38018-2279
US

IV. Provider business mailing address

560 TRINITY CREEK CV
CORDOVA TN
38018-2279
US

V. Phone/Fax

Practice location:
  • Phone: 901-249-5686
  • Fax: 901-343-0256
Mailing address:
  • Phone: 901-249-5686
  • Fax: 901-343-0256

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number1-26-2842151
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: