NPI Profile for ANNETTA M DAVENPORT in MARY ESTHER, FL.
Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Mental Health |
101YM0800X | |||
Addiction (Substance Use Disorder) |
101YA0400X | |||
Professional |
101YP2500X |
| NPI # | 1710294749 |
|
| Status | Active | |
| Credentials | LMHC (Licensed Mental Health Counselor) | |
| Entity | Individual | |
| Enumeration date | 09/13/2010 | |
| Last updated | 06/15/2011 - About 15 years ago | |
| Sole proprietor 1 | Yes | |
| Identifiers |
|
|
| Hospital affiliation(s) | Not Available |
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ANNETTA M DAVENPORT
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