Individual
KAITEY DAVIDSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
244 EAST AGATE AVE, GRANBY, CO 80446
(970) 887-2179
(970) 887-9311
Mailing address
715 HORIZON DR STE 225, GRAND JUNCTION, CO 81506-8743
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
08/15/2018
Last updated
03/06/2019
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