Provider Demographics
NPI:1568287381
Name:DAVIS, TOMMI-ANN (RBT)
Entity type:Individual
Prefix:
First Name:TOMMI-ANN
Middle Name:
Last Name:DAVIS
Suffix:
Gender:F
Credentials:RBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4227 GUNN HWY
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33618-8727
Mailing Address - Country:US
Mailing Address - Phone:347-561-1318
Mailing Address - Fax:
Practice Address - Street 1:4227 GUNN HWY
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33618-8727
Practice Address - Country:US
Practice Address - Phone:347-561-1318
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-11-18
Last Update Date:2024-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARBT-24-364466106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician