MEDICARE: MONIQUE DAVIS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	106E00000X	Assistant Behavior Analyst		CO

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	9994	OTHER		BCBS

General Provider Information

NPI Number	:	1528637592
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MONIQUE DAVIS

Provider Business Mailing Address
First Line	:	7635 BELAY HTS # 101
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80923-4338
Country	:	US
Telephone Number	:	301-266-9994
Fax Number	:

Provider Business Practice Location Address
First Line	:	7635 BELAY HTS # 101
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80923-4338
Country	:	US
Telephone Number	:	301-266-9994
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/23/2021
Last Update Date	:	04/01/2026

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Directions to “ MONIQUE DAVIS ” Practice Location

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