A psychologist, certified/licensed at the independent practice level in his/her state, who is duly trained and experienced in the delivery of direct, preventative, assessment, and therapeutic intervention services to individuals whose growth, adjustment, or functioning is actually impaired or is demonstrably at high risk of impairment (1974).
Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Health Service |
103TH0100X | 62 | Psychologist, Clinical | |
Mental Health |
101YM0800X | |||
Psychologist |
103T00000X | 62 | Psychologist, Clinical |
| NPI # | 1043421480 |
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| LBN Legal business name | AMELIA DAVENPORT, CONCINNITY GROUP | ||||||||||||
| Authorized official | AMELIA DAVENPORT - (OWNER) | ||||||||||||
| Entity | Organization | ||||||||||||
| Organization subpart 1 | No | ||||||||||||
| Enumeration date | 05/25/2007 | ||||||||||||
| Last updated | 01/04/2009 - About 17 years ago | ||||||||||||
| Identifiers |
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