Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Divon L Davis-Boddie

Individual provider Behavior Technician · NPI 1164274940

Divon L Davis-Boddie is a Behavior Technician in Glendale, Arizona. Licensed in Alaska. Registered with an NPI since 2024.

Licensed in
AK
In the registry since
2024

Practice location Address checks out

18330 N 79th Ave
Glendale, AZ 85308-8343
Phone: (907) 378-0463
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Behavior Technician (primary) Taxonomy 106S00000X · Licence 7560699 (AK)

Record details

NPI number1164274940
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedApril 4, 2024
Last updated in NPPESApril 4, 2024
Certification dateApril 3, 2024

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