Provider Demographics
NPI:1265746101
Name:DAVISON, ANDREA NICOLE (MA, BCBA)
Entity type:Individual
Prefix:
First Name:ANDREA
Middle Name:NICOLE
Last Name:DAVISON
Suffix:
Gender:F
Credentials:MA, BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6099 S QUEBEC ST STE 200
Mailing Address - Street 2:
Mailing Address - City:ENGLEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80111-4547
Mailing Address - Country:US
Mailing Address - Phone:720-442-2720
Mailing Address - Fax:
Practice Address - Street 1:6099 S QUEBEC ST STE 200
Practice Address - Street 2:
Practice Address - City:ENGLEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80111-4547
Practice Address - Country:US
Practice Address - Phone:720-442-2720
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-08-03
Last Update Date:2017-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst