Individual
BRIAN DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
5242 PLAINFIELD AVE NE STE A, GRAND RAPIDS, MI 49525
(616) 363-2200
(616) 363-5337
Mailing address
5242 PLAINFIELD AVE NE STE A, GRAND RAPIDS, MI 49525-1084
(616) 363-2200
(616) 363-5337
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
7401000675
MI
106E00000X
Assistant Behavior Analyst
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0-16-7571
BCABA
MI
Enumeration date
01/30/2017
Last updated
10/31/2019
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