| Doctor Name: | MRS. LAURA DAVENPORT |
| NPI Number: | 1285616912 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | LPC |
| License Number: | LPC003222 |
| Business Practice Address: | 1020 Barber Creek Dr Ste 213 Ste.213 Watkinsville, GA - 306775984 |
| Business Phone Number: | 7065489545 |
| Business Fax Number: | 7065489976 |
| Mailing Address: | Po Box 1558, WATKINSVILLE |
| State: | GA |
| Postal Code: | 306770031 |
| Phone Number: | 7065489545 |
| Fax Number: | 7065489976 |
| NPI Enumeration Date: | 11/17/2005 |
| NPI Last Update Date: | 05/22/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YM0800X |
| License Number: | LPC003222 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | GA |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Mental Health |
| Taxonomy Definition: | |