Provider Demographics
NPI:1184476293
Name:DAVIS, TRONA BRENAYE
Entity type:Individual
Prefix:
First Name:TRONA
Middle Name:BRENAYE
Last Name:DAVIS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3644 CHESTERFIELD AVE
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21213-1859
Mailing Address - Country:US
Mailing Address - Phone:667-770-3582
Mailing Address - Fax:
Practice Address - Street 1:3644 CHESTERFIELD AVE
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21213-1859
Practice Address - Country:US
Practice Address - Phone:667-770-3582
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-04-02
Last Update Date:2024-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician