Individual
AYESHA DAVENPORT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA, LPC
Contact information
Practice address
6618 S 23RD AVE, PHOENIX, AZ 85041-5358
(215) 206-7189
Mailing address
6618 S 23RD AVE, PHOENIX, AZ 85041-5358
(215) 206-7189
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
101YP2500X
Professional Counselor
Primary
AZ-16913
AZ
103K00000X
Behavior Analyst
—
—
Other
Enumeration date
01/20/2010
Last updated
01/09/2024
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