MEDICARE: DONTISHA R 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	101YP2500X	Professional Counselor	8010	LA
2	106S00000X	Behavior Technician

General Provider Information

NPI Number	:	1881186674
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DONTISHA R DAVIS

Provider Business Mailing Address
First Line	:	125 WELLNESS WAY
Second Line	:
City	:	HOT SPRINGS
State	:	AR
Zip	:	71913-6478
Country	:	US
Telephone Number	:	501-624-7111
Fax Number	:	501-620-5109

Provider Business Practice Location Address
First Line	:	125 WELLNESS WAY
Second Line	:
City	:	HOT SPRINGS
State	:	AR
Zip	:	71913-6478
Country	:	US
Telephone Number	:	501-624-7111
Fax Number	:	501-620-5109

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

Provider Enumeration Date	:	06/06/2018
Last Update Date	:	06/08/2026

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Directions to “ DONTISHA R DAVIS ” Practice Location

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