Individual
SUZANNA L DAVENPORT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
179 STATION PL, HURRICANE, WV 25526-6578
(304) 760-6300
(304) 201-5123
Mailing address
PO BOX 450, SCOTT DEPOT, WV 25560-0450
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
1940
WV
Other
Enumeration date
05/17/2019
Last updated
05/17/2019
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