Healthcare Provider Details

I. General information

NPI: 1073941753
Provider Name (Legal Business Name): CHRISTINE DAVIGNON
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/16/2013
Last Update Date: 10/16/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2111 CHAMPA ST
DENVER CO
80205-2529
US

IV. Provider business mailing address

1801 E GIRARD PL # 8-241
ENGLEWOOD CO
80113-3141
US

V. Phone/Fax

Practice location:
  • Phone: 303-312-9696
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TF0200X
TaxonomyForensic Psychologist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: