Individual
MRS. AUTUMN DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
529 WESTPORT RD, ELIZABETHTOWN, KY 42701-2949
(270) 763-8225
Mailing address
529 WESTPORT RD, ELIZABETHTOWN, KY 42701-2949
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
11/28/2017
Last updated
11/28/2017
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