Provider Demographics
NPI:1649093238
Name:DAVIS, TOSHA (MS, BCBA)
Entity type:Individual
Prefix:
First Name:TOSHA
Middle Name:
Last Name:DAVIS
Suffix:
Gender:F
Credentials:MS, BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10918 TEALPOINT DR
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46229-3430
Mailing Address - Country:US
Mailing Address - Phone:317-374-5827
Mailing Address - Fax:
Practice Address - Street 1:6169 W 300 N
Practice Address - Street 2:
Practice Address - City:GREENFIELD
Practice Address - State:IN
Practice Address - Zip Code:46140-9349
Practice Address - Country:US
Practice Address - Phone:317-622-8918
Practice Address - Fax:800-283-8703
Is Sole Proprietor?:No
Enumeration Date:2024-11-04
Last Update Date:2024-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN1-24-77078103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst