Individual
DONALD CHARLES DAVENPORT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
6735 SHORT LN, UPPER DARBY, PA 19082-4314
(267) 721-6735
Mailing address
6735 SHORT LN, UPPER DARBY, PA 19082-4314
(267) 721-5676
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
BH001344
PA
Other
Enumeration date
02/17/2018
Last updated
06/20/2018
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