Individual
BETTY JEAN DAVENPORT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
HOME HEALTH AID
Contact information
Practice address
3209 LIST ST NW, MASSILLON, OH 44646-2837
(330) 837-7796
Mailing address
3209 LIST ST NW, MASSILLON, OH 44646-2837
(330) 837-7796
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
2777786
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2777786
PROVIDER NUMBER
OH
Enumeration date
03/27/2008
Last updated
03/27/2008
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