Provider Demographics
NPI:1285269043
Name:ADAMS, DAVON DEJOUN
Entity type:Individual
Prefix:MR
First Name:DAVON
Middle Name:DEJOUN
Last Name:ADAMS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3712 GEORGETOWN CIR APT 3
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40215-1635
Mailing Address - Country:US
Mailing Address - Phone:502-994-5091
Mailing Address - Fax:
Practice Address - Street 1:3712 GEORGETOWN CIR APT 3
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40215-1635
Practice Address - Country:US
Practice Address - Phone:502-994-5091
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-03-11
Last Update Date:2020-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician