Provider Demographics
NPI:1326548199
Name:DAVIS, DAWN H (PHD, BCBA-D)
Entity Type:Individual
Prefix:DR
First Name:DAWN
Middle Name:H
Last Name:DAVIS
Suffix:
Gender:F
Credentials:PHD, BCBA-D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5950 MALLET CT
Mailing Address - Street 2:
Mailing Address - City:CUMMING
Mailing Address - State:GA
Mailing Address - Zip Code:30040-5710
Mailing Address - Country:US
Mailing Address - Phone:770-282-7676
Mailing Address - Fax:
Practice Address - Street 1:2450 ATLANTA HWY
Practice Address - Street 2:
Practice Address - City:CUMMING
Practice Address - State:GA
Practice Address - Zip Code:30040-8099
Practice Address - Country:US
Practice Address - Phone:770-282-7676
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-02-18
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst