Provider Demographics
NPI:1881717874
Name:DAVIS, SALLY ANN
Entity type:Individual
Prefix:MS
First Name:SALLY
Middle Name:ANN
Last Name:DAVIS
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 1:1635 COOK ST
Mailing Address - Street 2:#301
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80206-1845
Mailing Address - Country:US
Mailing Address - Phone:303-355-2438
Mailing Address - Fax:
Practice Address - Street 1:1810 S COLUMBINE ST
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80210-3407
Practice Address - Country:US
Practice Address - Phone:303-744-7371
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health