| Doctor Name: | DAVINA KAVANAUGH |
| NPI Number: | 1295856110 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | LLPC |
| License Number: | 6401009378 |
| Business Practice Address: | 148 N Riverview Dr Parchment, MI - 490041308 |
| Business Phone Number: | 2693440747 |
| Business Fax Number: | 2692260748 |
| Mailing Address: | 3718 Olney Rd, KALAMAZOO |
| State: | MI |
| Postal Code: | 490062863 |
| Phone Number: | 2693440747 |
| Fax Number: | 2692260748 |
| NPI Enumeration Date: | 04/02/2007 |
| NPI Last Update Date: | 10/28/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YP2500X |
| License Number: | 6401009378 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MI |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Professional |
| Taxonomy Definition: | |