Individual
CHARLES ROBERT DAVENPORT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PSY.D
Contact information
Practice address
1525 TAMIAMI TRL S, SUITE 603 A, VENICE, FL 34285-3568
(941) 321-1971
(941) 866-0936
Mailing address
1525 TAMIAMI TRL S, SUITE 603 A, VENICE, FL 34285-3568
(941) 321-1971
(941) 866-0936
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PY7978
FL
Other
Enumeration date
11/27/2007
Last updated
11/01/2011
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