Provider Demographics
NPI:1669943486
Name:DAVIS, LOUISE FREEMAN (PHD, BCBA, LBA)
Entity type:Individual
Prefix:DR
First Name:LOUISE
Middle Name:FREEMAN
Last Name:DAVIS
Suffix:
Gender:F
Credentials:PHD, BCBA, LBA
Other - Prefix:DR
Other - First Name:LOUISE
Other - Middle Name:MARGARET
Other - Last Name:FREEMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHD, BCBA, LBA
Mailing Address - Street 1:4890 MECHUMS RIVER RD
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTESVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:22901-9209
Mailing Address - Country:US
Mailing Address - Phone:540-887-7030
Mailing Address - Fax:
Practice Address - Street 1:4890 MECHUMS RIVER RD
Practice Address - Street 2:
Practice Address - City:CHARLOTTESVILLE
Practice Address - State:VA
Practice Address - Zip Code:22901-9209
Practice Address - Country:US
Practice Address - Phone:434-242-6532
Practice Address - Fax:434-216-3491
Is Sole Proprietor?:Yes
Enumeration Date:2018-12-06
Last Update Date:2024-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA01330012432103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty