Individual
MR. MICHAEL PATRICK DAVENPORT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
1002 HIGHLAND AVE, STE 300, SHREVEPORT, LA 71101-4143
(318) 222-6226
(318) 221-8526
Mailing address
1002 HIGHLAND AVE, STE 300, SHREVEPORT, LA 71101
(318) 222-6226
(318) 221-8526
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
464
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
721409091001
HUMANA MILITARY
LA
Enumeration date
06/27/2006
Last updated
07/08/2007
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