Organization
CHARLES R DAVENPORT PSYD LLC
Active
Other names
Davenport Psychology
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CHARLES ROBERT DAVENPORT PSY.D. (MANAGING MEMBER)
(941) 321-1971
Entity
Organization
Contact information
Practice address
1608 OAK ST, SARASOTA, FL 34236-7517
(941) 321-1971
Mailing address
1608 OAK ST # 1608, SARASOTA, FL 34236-7517
(941) 321-1971
(941) 866-0936
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PY7978
FL
103TC2200X
Clinical Child & Adolescent Psychologist
PY7978
FL
103TF0000X
Family Psychologist
PY7978
FL
Other
Enumeration date
10/16/2011
Last updated
06/10/2021
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