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NPI Code Detail

MEDICARE: KYLEE DAVIDSON BSW

MEDICARE: KYLEE DAVIDSON BSW
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
1104100000XSocial Worker

General Provider Information

NPI Number : 1093582793
Entity Type Code : Individual
Provider Name (Legal Business Name) : KYLEE DAVIDSON BSW
Provider Business Mailing Address
First Line : 1925 DOMINION WAY FL 1
Second Line :
City : COLORADO SPRINGS
State : CO
Zip : 80918-1483
Country : US
Telephone Number : 719-300-5735
Fax Number :
Provider Business Practice Location Address
First Line : 1925 DOMINION WAY FL 1
Second Line :
City : COLORADO SPRINGS
State : CO
Zip : 80918-1483
Country : US
Telephone Number : 719-300-5735
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/04/2023
Last Update Date : 12/04/2023

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Directions to “ KYLEE DAVIDSON BSW” Practice Location

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