Doctor Name: | DENESHIA DAVENPORT |
NPI Number: | 1134453939 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MAPC |
License Number: | |
Business Practice Address: | 1751 Meriweather Dr Bldg B Bogart, GA - 306223092 |
Business Phone Number: | 7065434887 |
Business Fax Number: | 7065434889 |
Mailing Address: | 1751 Meriweather Dr Bldg B, BOGART |
State: | GA |
Postal Code: | 306223092 |
Phone Number: | 7065434887 |
Fax Number: | 7065434889 |
NPI Enumeration Date: | 09/25/2009 |
NPI Last Update Date: | 09/25/2009 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |