Provider Demographics
NPI:1992467369
Name:DAVIS, ALESKA (MS)
Entity Type:Individual
Prefix:
First Name:ALESKA
Middle Name:
Last Name:DAVIS
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 WATTS WAY SW
Mailing Address - Street 2:
Mailing Address - City:ROME
Mailing Address - State:GA
Mailing Address - Zip Code:30165-3951
Mailing Address - Country:US
Mailing Address - Phone:470-800-9423
Mailing Address - Fax:
Practice Address - Street 1:10 WATTS WAY SW
Practice Address - Street 2:
Practice Address - City:ROME
Practice Address - State:GA
Practice Address - Zip Code:30165-3951
Practice Address - Country:US
Practice Address - Phone:470-800-9423
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-10-12
Last Update Date:2021-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist