NPI 1023902590

Ethan Lane Davis

Practitioner Behavior Technician Cleveland, TN

Practice location

Address: 177 Mouse Creek Rd NW, Cleveland, TN 37312-3838
Phone: (888) 963-2228
Mailing address: 2409 Georgetown Rd NW, Cleveland, TN 37311-3553

Registered specialties

Behavior Technician Primary

Behavioral Health & Social Service Providers Taxonomy 106S00000X Licence RBT-25-442247 (TN)

Other Behavior Technician providers in Tennessee →

Registry record

NPI: 1023902590
Entity type: Individual
Sex (as registered): Male
NPI issued: 7 Jun 2025
Record last updated: 14 May 2026

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.