Healthcare Provider Details

I. General information

NPI: 1386558278
Provider Name (Legal Business Name): TABITHA DAVISON
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/29/2026
Last Update Date: 09/29/2026
Certification Date: 09/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

19750 E PARKER SQUARE DR STE 105
PARKER CO
80134-7302
US

IV. Provider business mailing address

19750 E PARKER SQUARE DR STE 105
PARKER CO
80134-7302
US

V. Phone/Fax

Practice location:
  • Phone: 720-340-7000
  • Fax:
Mailing address:
  • Phone: 720-340-7000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: