Individual
KELLY DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
22 CLARKE ST APT 2, BURLINGTON, VT 05401-3754
(603) 785-3976
Mailing address
22 CLARKE ST APT 2, BURLINGTON, VT 05401-3754
(603) 785-3976
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
04/22/2021
Last updated
08/03/2021
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