Ethan Davis
Behavior Technician in Fredericksburg, VA. Individual provider (NPI-1).
NPI number1609613298
StatusActive
Last updated in NPPESJun 2, 2025
Details
- NPI
- 1609613298
- Entity type
- Individual (NPI-1)
- Name
- Ethan Davis
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Jul 10, 2024
- Certification date
- Jun 2, 2025
- Last updated
- Jun 2, 2025
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 106S00000X | Behavior Technician | – | – | Yes |
Practice location
4201 Bridlepath CtFredericksburg, VA 22408-8813
Phone 540-847-1936
Mailing address
4201 Bridlepath CtFredericksburg, VA 22408-8813
Phone 540-847-1936
Is something wrong?
This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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All 285 Behavior Technician providers in Fredericksburg · All 4,989 providers in Fredericksburg
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