Individual
DIANA ELIZABETH DAVENPORT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
1207 CLEARVIEW ST SW, DECATUR, AL 35601-6211
(256) 350-4732
Mailing address
1207 CLEARVIEW ST SW, DECATUR, AL 35601-6211
(256) 350-4732
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
871
TN
Other
Enumeration date
11/15/2006
Last updated
07/08/2007
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