MEDICARE: AKILAH DAVIS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	106S00000X	Behavior Technician

General Provider Information

NPI Number	:	1316702293
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AKILAH DAVIS

Provider Business Mailing Address
First Line	:	144 N DELLROSE AVE
Second Line	:
City	:	WICHITA
State	:	KS
Zip	:	67208-3920
Country	:	US
Telephone Number	:	347-273-0811
Fax Number	:

Provider Business Practice Location Address
First Line	:	2024 N WOODLAWN ST STE 402
Second Line	:
City	:	WICHITA
State	:	KS
Zip	:	67208-1879
Country	:	US
Telephone Number	:	316-201-6424
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/19/2024
Last Update Date	:	02/19/2024

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Directions to “ AKILAH DAVIS ” Practice Location

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