Provider Demographics
NPI:1497408959
Name:DAVISON, EMILY
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:
Last Name:DAVISON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:81 BEAVER DAM RD
Mailing Address - Street 2:
Mailing Address - City:NORTH WATERBORO
Mailing Address - State:ME
Mailing Address - Zip Code:04061-4732
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:81 BEAVER DAM RD
Practice Address - Street 2:
Practice Address - City:NORTH WATERBORO
Practice Address - State:ME
Practice Address - Zip Code:04061-4732
Practice Address - Country:US
Practice Address - Phone:207-651-7535
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-02-03
Last Update Date:2022-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer