Provider Demographics
NPI:1265906549
Name:DAVIS, JESSICA ALEXIS (MS, LBA, BCBA)
Entity type:Individual
Prefix:
First Name:JESSICA
Middle Name:ALEXIS
Last Name:DAVIS
Suffix:
Gender:F
Credentials:MS, LBA, BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3101 BRUSHY MOUNTAIN ST
Mailing Address - Street 2:
Mailing Address - City:CARY
Mailing Address - State:NC
Mailing Address - Zip Code:27519-7232
Mailing Address - Country:US
Mailing Address - Phone:919-842-9846
Mailing Address - Fax:
Practice Address - Street 1:210 TALSROCK WAY STE 3
Practice Address - Street 2:
Practice Address - City:CARY
Practice Address - State:NC
Practice Address - Zip Code:27519-1906
Practice Address - Country:US
Practice Address - Phone:919-745-8892
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-01-19
Last Update Date:2025-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst