Provider Demographics
NPI:1194618017
Name:DAVIS, KAYLEE (RBT)
Entity type:Individual
Prefix:
First Name:KAYLEE
Middle Name:
Last Name:DAVIS
Suffix:
Gender:F
Credentials:RBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3305 S G ST
Mailing Address - Street 2:
Mailing Address - City:ELWOOD
Mailing Address - State:IN
Mailing Address - Zip Code:46036-9778
Mailing Address - Country:US
Mailing Address - Phone:765-415-2023
Mailing Address - Fax:
Practice Address - Street 1:1030 N SR 37
Practice Address - Street 2:
Practice Address - City:ELWOOD
Practice Address - State:IN
Practice Address - Zip Code:46036
Practice Address - Country:US
Practice Address - Phone:765-617-2279
Practice Address - Fax:765-274-5244
Is Sole Proprietor?:No
Enumeration Date:2025-05-30
Last Update Date:2025-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
INRBT-25-417519106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician