Individual
AMANDA DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RBT
Contact information
Practice address
555 AUBURN ST, MANCHESTER, NH 03103-4803
(603) 621-3407
(603) 622-8101
Mailing address
555 AUBURN ST, MANCHESTER, NH 03103-4803
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-16-23890
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
RBT-16-23890
BACB
—
Enumeration date
09/19/2017
Last updated
09/19/2017
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