Provider Demographics
NPI:1265298277
Name:DAVIS, CALVIN
Entity type:Individual
Prefix:
First Name:CALVIN
Middle Name:
Last Name:DAVIS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:KEY AUTISM 13585 HWY 35
Mailing Address - Street 2:284
Mailing Address - City:MIDDLETON
Mailing Address - State:NJ
Mailing Address - Zip Code:07748
Mailing Address - Country:US
Mailing Address - Phone:470-992-4133
Mailing Address - Fax:
Practice Address - Street 1:KEY AUTISM 13585 HWY 35
Practice Address - Street 2:284
Practice Address - City:MIDDLETON
Practice Address - State:NJ
Practice Address - Zip Code:07748
Practice Address - Country:US
Practice Address - Phone:470-992-4133
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-02-27
Last Update Date:2024-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician