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General NPI Number Information
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NPI Number | 1245035435
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Entity Type | Individual
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Provider Name | DEANNA DAVIDSON RBT
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Gender | Female
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Dates
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Enumeration Date | 02/13/2025
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Last Update Date | 10/17/2025
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Provider Practice Location Address
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Address Line | 1923 S LIBERTY DR
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City | BLOOMINGTON
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State | IN
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Zip | 47403-5146
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Country | US
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Telephone | 812-330-4460
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Fax | 812-330-4461
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Provider Business Mailing Address
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Address Line | 4888 S ROGERS ST
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City | CLEAR CREEK
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State | IN
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Zip | 47426-9201
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Country | US
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Telephone | 812-330-4460
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Fax | 812-330-4461
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106S00000X
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Taxonomy Name | Behavior Technician
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License Number | RBT-25-410495
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License Number State | IN
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