Individual
CELIA DAWN DAVENPORT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MAT, LBS1
Contact information
Practice address
304 N LOOMIS ST, CHICAGO, IL 60607-1147
(312) 243-8487
(888) 733-1772
Mailing address
1829 N ALBANY AVE, CHICAGO, IL 60647-5011
(312) 243-8487
(888) 733-1772
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
989306
IL
Other
Enumeration date
08/04/2016
Last updated
08/04/2016
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