Provider Demographics
NPI:1447736244
Name:DAVIS, KALEIGH DEFREECE (MS, BCBA)
Entity Type:Individual
Prefix:
First Name:KALEIGH
Middle Name:DEFREECE
Last Name:DAVIS
Suffix:
Gender:F
Credentials:MS, BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4188 HILLDALE AVE
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38117-1628
Mailing Address - Country:US
Mailing Address - Phone:901-626-7723
Mailing Address - Fax:
Practice Address - Street 1:4188 HILLDALE AVE
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38117-1628
Practice Address - Country:US
Practice Address - Phone:901-626-7723
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-07-14
Last Update Date:2022-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN1619132917103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst