Provider Demographics
NPI:1548933641
Name:DAVIS-HINTON, MICHAESHA
Entity type:Individual
Prefix:MRS
First Name:MICHAESHA
Middle Name:
Last Name:DAVIS-HINTON
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 1:10147 GRAND AVE STE B-5
Mailing Address - Street 2:
Mailing Address - City:SUN CITY
Mailing Address - State:AZ
Mailing Address - Zip Code:85351-3435
Mailing Address - Country:US
Mailing Address - Phone:480-729-5975
Mailing Address - Fax:
Practice Address - Street 1:10147 GRAND AVE STE B-5
Practice Address - Street 2:
Practice Address - City:SUN CITY
Practice Address - State:AZ
Practice Address - Zip Code:85351-3435
Practice Address - Country:US
Practice Address - Phone:480-729-5975
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-07-26
Last Update Date:2023-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician
No171M00000XOther Service ProvidersCase Manager/Care Coordinator
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health