Individual
CAROLIN DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BCBA
Contact information
Practice address
5306 CREEKMUR DR, LAKELAND, FL 33812-4012
(863) 777-0640
Mailing address
5306 CREEKMUR DR, LAKELAND, FL 33812-4012
(863) 777-0640
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
11622830
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
019674300
—
FL
Enumeration date
06/27/2016
Last updated
02/26/2025
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