Provider Demographics
NPI:1568983013
Name:DAVIS, SARA (MA)
Entity Type:Individual
Prefix:
First Name:SARA
Middle Name:
Last Name:DAVIS
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2811 W 27TH AVE APT 9
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80211-4159
Mailing Address - Country:US
Mailing Address - Phone:720-212-1606
Mailing Address - Fax:
Practice Address - Street 1:1728 N DOWNING ST
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80218-1008
Practice Address - Country:US
Practice Address - Phone:303-377-2820
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-07-05
Last Update Date:2017-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator