Individual
SAMANTHA LEE DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.ED, BCBA
Contact information
Practice address
22461 I-30 FRONTAGE RD, 1100B, BRYANT, AR 72022
(501) 574-3053
Mailing address
22641 FRONTAGE RD, BRYANT, AR 72022-9117
(501) 547-3053
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-18-31009
—
106E00000X
Assistant Behavior Analyst
C-022
LA
Other
Enumeration date
10/12/2017
Last updated
11/15/2018
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