Individual
AMANDA ROBIN DAVENPORT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
L.P.C.
Contact information
Practice address
807 NW 137TH ST, EDMOND, OK 73013-1952
(405) 919-9210
Mailing address
807 NW 137TH ST, EDMOND, OK 73013-1952
(405) 919-9210
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
3737
OK
Other
Enumeration date
09/19/2007
Last updated
09/19/2007
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