Individual
DEBRA L DAVENPORT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA, SPE
Contact information
Practice address
198 W MAIN ST, CAMDEN, TN 38320-1609
(731) 584-1012
(731) 584-3102
Mailing address
12595 HIGHWAY 69A, BIG SANDY, TN 38221-5066
(731) 584-1012
(731) 584-3102
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
PE 11334
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5441084
—
TN
Enumeration date
03/12/2007
Last updated
07/08/2007
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