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Individual

MISS ELAINE BLANCHE DAVENPORT

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.S. SPEECH PATHOLO

Contact information

Practice address
5905 O ST, LINCOLN, NE 68510-2235
(402) 436-1000
Mailing address
5905 O ST, LINCOLN, NE 68510-2235
(402) 436-1000
(402) 330-5970

Taxonomy

Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
1274
NE
3747A0650X
Attendant Care Provider
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
47065477700
NE
Enumeration date
12/10/2012
Last updated
01/26/2023
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