Individual
DARIC DAVENPORT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
67 EUSTIS PKWY, WATERVILLE, ME 04901-5173
(207) 873-2136
Mailing address
67 EUSTIS PKWY, WATERVILLE, ME 04901-5173
(207) 716-7041
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
MC16853
ME
1041C0700X
Clinical Social Worker
Primary
LC18546
ME
Other
Enumeration date
10/12/2017
Last updated
02/28/2020
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