Provider Demographics
NPI:1700835873
Name:DAVIS, RONALD LEE (PHD,BCBA-D)
Entity Type:Individual
Prefix:DR
First Name:RONALD
Middle Name:LEE
Last Name:DAVIS
Suffix:
Gender:M
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 1:9297 LEES RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:WARRENTON
Mailing Address - State:VA
Mailing Address - Zip Code:20186-8663
Mailing Address - Country:US
Mailing Address - Phone:979-255-3534
Mailing Address - Fax:
Practice Address - Street 1:9297 LEES RIDGE RD
Practice Address - Street 2:
Practice Address - City:WARRENTON
Practice Address - State:VA
Practice Address - Zip Code:20186-8663
Practice Address - Country:US
Practice Address - Phone:979-255-3534
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-08
Last Update Date:2015-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX21817103T00000X
VA0133000462103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No103T00000XBehavioral Health & Social Service ProvidersPsychologist