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Individual
MISTY DAVENPORT
Active
Individual
MISTY DAVENPORT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
103K00000X
Behavior Analyst
—
—
106S00000X
Behavior Technician
Primary
—
—
235Z00000X
Speech-Language Pathologist
—
—
Other
Enumeration date
01/21/2015
Last updated
07/05/2018
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