Individual
ETHAN DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
4201 BRIDLEPATH CT, FREDERICKSBURG, VA 22408-8813
(540) 847-1936
Mailing address
4201 BRIDLEPATH CT, FREDERICKSBURG, VA 22408-8813
(540) 847-1936
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
07/10/2024
Last updated
06/02/2025
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