Individual
MS. ANNETTA M. G. DAVENPORT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMHC
Contact information
Practice address
124 E MIRACLE STRIP PKWY STE 204, MARY ESTHER, FL 32569-1990
(850) 226-7100
(850) 226-7157
Mailing address
124 E MIRACLE STRIP PKWY STE 204, MARY ESTHER, FL 32569-1990
(850) 226-7100
(850) 226-7157
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
MH9997
FL
101YM0800X
Mental Health Counselor
Primary
MH9997
FL
101YP2500X
Professional Counselor
MH9997
FL
Other
Enumeration date
09/13/2010
Last updated
06/15/2011
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