Individual
BRANDY LEE DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
115 ROTTINGHAM CT STE A, EDWARDSVILLE, IL 62025-3677
(217) 525-8332
(618) 692-5204
Mailing address
4559 BENES STREET, GLEN CARBON, IL 62034
(217) 525-8332
(618) 692-5204
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-18-33462
IL
106S00000X
Behavior Technician
—
IL
Other
Enumeration date
06/25/2018
Last updated
09/06/2022
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