Provider Demographics
NPI:1467716845
Name:DAVISON, KRISTA (AUD)
Entity Type:Individual
Prefix:DR
First Name:KRISTA
Middle Name:
Last Name:DAVISON
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 INDUSTRIAL PARK DR
Mailing Address - Street 2:
Mailing Address - City:CONCORD
Mailing Address - State:NH
Mailing Address - Zip Code:03301-8520
Mailing Address - Country:US
Mailing Address - Phone:603-224-9043
Mailing Address - Fax:603-228-2133
Practice Address - Street 1:2 INDUSTRIAL PARK DR
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:NH
Practice Address - Zip Code:03301-8520
Practice Address - Country:US
Practice Address - Phone:603-224-9043
Practice Address - Fax:603-228-2133
Is Sole Proprietor?:No
Enumeration Date:2012-06-29
Last Update Date:2020-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NHIA612231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist