Individual
MS. WILMA MAE DAVENPORT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
L.C.S.W.
Contact information
Practice address
SIDNEY & LAMONT ST., MOUNTAIN HOME, TN 37684
(423) 979-2613
Mailing address
2217 NANTUCKET DR, JOHNSON CITY, TN 37604-3362
(423) 926-1652
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
C004766
NC
Other
Enumeration date
08/31/2006
Last updated
07/08/2007
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