Individual
DARIC DAVENPORT
Active
Individual
DARIC DAVENPORT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCSW
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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