Individual
BRAELYN DAVENPORT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2208 S JEFFERSON ST APT 1, CASPER, WY 82601-5528
(307) 253-9308
(307) 251-5521
Mailing address
2208 S JEFFERSON ST APT 1, CASPER, WY 82601-5528
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
11/02/2023
Last updated
11/02/2023
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