Provider Demographics
NPI:1740753540
Name:DAY, DAMON
Entity Type:Individual
Prefix:MR
First Name:DAMON
Middle Name:
Last Name:DAY
Suffix:
Gender:M
Credentials:
Other - Prefix:MR
Other - First Name:DAMON
Other - Middle Name:
Other - Last Name:DAY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:2301 TANFIELD DR
Mailing Address - Street 2:
Mailing Address - City:MATTHEWS
Mailing Address - State:NC
Mailing Address - Zip Code:28105-0814
Mailing Address - Country:US
Mailing Address - Phone:980-395-9773
Mailing Address - Fax:
Practice Address - Street 1:420 HAWTHORNE LN
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28204-2312
Practice Address - Country:US
Practice Address - Phone:703-780-4271
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-01-04
Last Update Date:2021-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL106S00000X
106E00000X, 103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician
No106E00000XBehavioral Health & Social Service ProvidersAssistant Behavior Analyst