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NPI Code Detail

MEDICARE: KIERRA NOEL DAVIS

MEDICARE: KIERRA NOEL 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
1103K00000XBehavior AnalystMD

General Provider Information

NPI Number : 1699267914
Entity Type Code : Individual
Provider Name (Legal Business Name) : KIERRA NOEL DAVIS
Provider Business Mailing Address
First Line : 10015 OLD COLUMBIA RD STE F100
Second Line :
City : COLUMBIA
State : MD
Zip : 21046-1755
Country : US
Telephone Number : 443-741-8788
Fax Number :
Provider Business Practice Location Address
First Line : 10015 OLD COLUMBIA RD STE F100
Second Line :
City : COLUMBIA
State : MD
Zip : 21046-1755
Country : US
Telephone Number : 443-741-8788
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/01/2018
Last Update Date : 06/01/2018

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Directions to “ KIERRA NOEL DAVIS ” Practice Location

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