Provider Demographics
NPI:1093582793
Name:DAVIDSON, KYLEE (BSW)
Entity Type:Individual
Prefix:
First Name:KYLEE
Middle Name:
Last Name:DAVIDSON
Suffix:
Gender:F
Credentials:BSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1925 DOMINION WAY FL 1
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80918-1483
Mailing Address - Country:US
Mailing Address - Phone:719-300-5735
Mailing Address - Fax:
Practice Address - Street 1:1925 DOMINION WAY FL 1
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80918-1483
Practice Address - Country:US
Practice Address - Phone:719-300-5735
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-12-04
Last Update Date:2023-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker