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NPI Code Detail

MEDICARE: SUSAN DAVISON BCBA

MEDICARE:   SUSAN  DAVISON  BCBA
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 Analyst1-07-3766MA

General Provider Information

NPI Number : 1891060976
Entity Type Code : Individual
Provider Name (Legal Business Name) : SUSAN DAVISON BCBA
Provider Business Mailing Address
First Line : 6 SOUTHSIDE RD
Second Line :
City : DANVERS
State : MA
Zip : 01923-1409
Country : US
Telephone Number : 978-624-2340
Fax Number :
Provider Business Practice Location Address
First Line : 100 CUMMINGS CTR STE 135C
Second Line :
City : BEVERLY
State : MA
Zip : 01915-6263
Country : US
Telephone Number : 978-473-7300
Fax Number : 978-969-0083
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/21/2012
Last Update Date : 05/09/2024

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Directions to “ SUSAN DAVISON BCBA” Practice Location

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