Individual
JANE W DAVENPORT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CCC-SLP
Contact information
Practice address
604 WASHINGTON ST NW STE B2, GAINESVILLE, GA 30501-8545
(770) 534-5141
(770) 534-5141
Mailing address
2612 PINEBROOK DR, GAINESVILLE, GA 30506-1808
(770) 712-9832
(770) 534-5141
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SLP-005646
GA
Other
Enumeration date
08/11/2014
Last updated
08/11/2014
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