Individual
MR. KENNETH MICHAEL DAVISON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MSW
Contact information
Practice address
1304 CHINOOK LN, PUEBLO, CO 81001
(719) 545-2746
Mailing address
1304 CHINOOK LN, PUEBLO, CO 81001
(719) 545-2746
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Enumeration date
09/03/2008
Last updated
09/03/2008
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