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Individual

DIANNE DAVENPORT

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LCSW

Contact information

Practice address
3723 W 12600 S STE 330, RIVERTON, UT 84065-7309
(385) 622-0353
Mailing address
3723 W 12600 S STE 330, RIVERTON, UT 84065-7309
(385) 622-0353

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
12727539-3501
UT

Other

Enumeration date
04/10/2024
Last updated
04/10/2024
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