Provider Demographics
NPI:1063156149
Name:DAVIS, NZINGA GBEA
Entity type:Individual
Prefix:MRS
First Name:NZINGA
Middle Name:GBEA
Last Name:DAVIS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:212 BRIDGE ST APT E
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:OH
Mailing Address - Zip Code:45005-1658
Mailing Address - Country:US
Mailing Address - Phone:816-301-1405
Mailing Address - Fax:
Practice Address - Street 1:212 BRIDGE ST APT E
Practice Address - Street 2:
Practice Address - City:FRANKLIN
Practice Address - State:OH
Practice Address - Zip Code:45005-1658
Practice Address - Country:US
Practice Address - Phone:816-301-1405
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-04-25
Last Update Date:2022-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TM1800XBehavioral Health & Social Service ProvidersPsychologistIntellectual & Developmental Disabilities