Individual
BRUCE DAVENPORT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1820 PAUL DR, JEFFERSON CITY, TN 37760-5229
(423) 312-4687
Mailing address
1820 PAUL DR, JEFFERSON CITY, TN 37760-5229
(423) 312-4687
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
LPC0000000729
TN
Other
Enumeration date
12/05/2023
Last updated
12/05/2023
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