Individual
CARISSA DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1834 FIELDS BLVD, GREENFIELD, IN 46140-3029
(574) 387-4313
Mailing address
1827 E IRELAND RD, SOUTH BEND, IN 46614-2845
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-25-487951
IN
Other
Enumeration date
11/06/2025
Last updated
11/06/2025
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