Individual
AUSTIN DAVENPORT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LPC
Contact information
Practice address
2475 LAKEWOOD DR, GRAND PRAIRIE, TX 75054-6801
(281) 389-8079
Mailing address
509 HIGH RIDGE DR, FRIENDSWOOD, TX 77546-3669
(281) 389-8079
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
72790
TX
101YM0800X
Mental Health Counselor
72790
TX
101YP2500X
Professional Counselor
Primary
72790
TX
Other
Enumeration date
08/03/2023
Last updated
08/03/2023
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