Organization
M PATRICK DAVENPORT APPC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MICHAEL PATRICK DAVENPORT PHD (OWNER)
(318) 518-5001
Entity
Organization
Contact information
Practice address
1002 HIGHLAND AVE, 3RD FLOOR, SHREVEPORT, LA 71101-4143
(318) 222-6226
(318) 222-6227
Mailing address
1002 HIGHLAND AVE, 2ND FLOOR, SHREVEPORT, LA 71101-4143
(318) 222-6226
(318) 222-6227
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
464
LA
Other
Enumeration date
03/14/2011
Last updated
05/10/2011
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