| Organization Name: | SUSAN F DAVENPORT PHD INC |
| NPI Number: | 1043332778 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | SUSAN F DAVENPORT (OWNER) |
| Mailing Address: | 121 Carl Vinson Parkway Warner Robins |
| State: | GA US |
| Postal Code: | 31088 |
| Phone Number: | 4789222365 |
| Fax Number: | 4789221778 |
| NPI Enumeration Date: | 04/04/2007 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 103TC0700X |
| License Number: | 1969 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | GA |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Psychologist |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | |