Individual
DIAMOND DEJA DAVENPORT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2369 2ND AVE, NEW YORK, NY 10035-3108
(212) 876-2300
(212) 722-7618
Mailing address
2369 2ND AVE, NEW YORK, NY 10035-3108
(212) 876-2300
(212) 722-7618
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
02/19/2021
Last updated
02/19/2021
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