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NPI Code Detail

MEDICARE: ELISA DAVILA

MEDICARE:   ELISA  DAVILA
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
1106S00000XBehavior Technician

General Provider Information

NPI Number : 1730037615
Entity Type Code : Individual
Provider Name (Legal Business Name) : ELISA DAVILA
Provider Business Mailing Address
First Line : 34937 S LASSO LN
Second Line :
City : RED ROCK
State : AZ
Zip : 85145-4006
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 34937 S LASSO LN
Second Line :
City : RED ROCK
State : AZ
Zip : 85145-4006
Country : US
Telephone Number : 619-657-9294
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/18/2026
Last Update Date : 03/18/2026

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Directions to “ ELISA DAVILA ” Practice Location

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