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General NPI Number Information
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NPI Number | 1669254033
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Entity Type | Individual
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Provider Name | ELLEN DAVIS
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Gender | Female
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Dates
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Enumeration Date | 10/19/2023
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Last Update Date | 01/03/2025
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Provider Practice Location Address
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Address Line | 102 SCALES PL
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City | GREENVILLE
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State | NC
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Zip | 27834-7202
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Country | US
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Telephone | 919-375-0475
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Fax |
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Provider Business Mailing Address
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Address Line | 1408 JOEL DR UNIT B
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City | GREENVILLE
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State | NC
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Zip | 27834-0424
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Country | US
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Telephone |
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Fax |
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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 | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number | 1-25-78747
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License Number State |
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Taxonomy #2
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number | 14808
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License Number State |
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Taxonomy #3
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number | 1629
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License Number State | NC
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