Provider Demographics
NPI:1164006490
Name:DAVIS, DORIS MICHELLE (BCBA PHD)
Entity Type:Individual
Prefix:DR
First Name:DORIS
Middle Name:MICHELLE
Last Name:DAVIS
Suffix:
Gender:F
Credentials:BCBA PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1616 VASSAR ST
Mailing Address - Street 2:
Mailing Address - City:SAVANNAH
Mailing Address - State:GA
Mailing Address - Zip Code:31405-3861
Mailing Address - Country:US
Mailing Address - Phone:912-661-6222
Mailing Address - Fax:
Practice Address - Street 1:1616 VASSAR ST
Practice Address - Street 2:
Practice Address - City:SAVANNAH
Practice Address - State:GA
Practice Address - Zip Code:31405-3861
Practice Address - Country:US
Practice Address - Phone:912-661-6222
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-05-12
Last Update Date:2024-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA1-21-57342103K00000X
GA0-21-12051106E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106E00000XBehavioral Health & Social Service ProvidersAssistant Behavior Analyst
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst