Individual
DR. LISA CAROL T DAVENPORT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
17100 ROYAL PALM BOULEVARD, SUITE ONE, WESTON, FL 33326
(954) 217-2444
(954) 217-9292
Mailing address
1931 NW 150TH AVE STE 116, PEMBROKE PINES, FL 33028-2873
(786) 383-1856
(786) 431-4872
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PY7447
FL
Other
Enumeration date
03/05/2007
Last updated
07/30/2021
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