Provider Demographics
NPI:1043735418
Name:DAVIDS, CHRISTOPHER M
Entity Type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:M
Last Name:DAVIDS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:123 W ARBROATH LN
Mailing Address - Street 2:
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84115-5009
Mailing Address - Country:US
Mailing Address - Phone:1720-771-6918
Mailing Address - Fax:
Practice Address - Street 1:439 E 900 S FL 2
Practice Address - Street 2:
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84111-4303
Practice Address - Country:US
Practice Address - Phone:385-313-0947
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-08-07
Last Update Date:2017-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist