Healthcare Provider Details

I. General information

NPI: 1336076876
Provider Name (Legal Business Name): KIARA RASHANTA JOYCE DAVIS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/07/2026
Last Update Date: 05/07/2026
Certification Date: 05/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4001 VIRGINIA BEACH BLVD STE 117
VIRGINIA BEACH VA
23452-1759
US

IV. Provider business mailing address

1742 WOODMILL ST
CHESAPEAKE VA
23320-0629
US

V. Phone/Fax

Practice location:
  • Phone: 855-832-6727
  • Fax:
Mailing address:
  • Phone: 757-620-5864
  • 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: