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Individual

RYAN DAVIS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
5905 O ST, LINCOLN, NE 68510-2235
(402) 436-1905
Mailing address
5905 O ST, LINCOLN, NE 68510-2235
(402) 890-9429

Taxonomy

Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-22-233819
NE
3747A0650X
Attendant Care Provider

Other

Enumeration date
03/29/2022
Last updated
09/13/2022
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