Provider Demographics
NPI:1104057835
Name:DAVIDSON, SUZANNE RENEE (MS, CGC)
Entity type:Individual
Prefix:MRS
First Name:SUZANNE
Middle Name:RENEE
Last Name:DAVIDSON
Suffix:
Gender:F
Credentials:MS, CGC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6219 NORTHSTAR RIDGE LN
Mailing Address - Street 2:
Mailing Address - City:PARKER
Mailing Address - State:CO
Mailing Address - Zip Code:80134-5757
Mailing Address - Country:US
Mailing Address - Phone:303-841-8133
Mailing Address - Fax:303-805-8290
Practice Address - Street 1:6219 NORTHSTAR RIDGE LN
Practice Address - Street 2:
Practice Address - City:PARKER
Practice Address - State:CO
Practice Address - Zip Code:80134-5757
Practice Address - Country:US
Practice Address - Phone:303-841-8133
Practice Address - Fax:303-805-8290
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-29
Last Update Date:2009-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes170300000XOther Service ProvidersGenetic Counselor, MS