Individual
OLIVIA DAVENPORT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
6 LEDGEBROOK DR FL 2, MANSFIELD CENTER, CT 06250-1644
(860) 833-2657
Mailing address
6 LEDGEBROOK DR, MANSFIELD CENTER, CT 06250-1644
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
6555
CT
Other
Enumeration date
12/09/2024
Last updated
12/09/2024
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