Individual
BRANDON DAVENPORT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
812 SHEPARD ST, MOREHEAD CITY, NC 28557-4250
(252) 726-2587
(252) 726-8611
Mailing address
812 SHEPARD ST, MOREHEAD CITY, NC 28557-4250
(252) 726-2587
(252) 726-8611
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
7154
NC
Other
Enumeration date
07/07/2009
Last updated
07/07/2009
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