Individual
TAKEITHAYA Q DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
225 CEDAR HILL ST, MARLBOROUGH, MA 01752-5900
(857) 829-4040
Mailing address
1859 PETITE LN, LITHONIA, GA 30058-7835
(678) 920-1601
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-26-90952
GA
106S00000X
Behavior Technician
RBT-21-169-167
GA
Other
Enumeration date
05/27/2021
Last updated
07/29/2026
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