Individual
MISS CHRISTY DENICE DAVENPORT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR
Contact information
Practice address
1200 N ELM ST, GREENSBORO, NC 27401-1004
(336) 832-7363
Mailing address
107 SHORELAKE DR, APT E, GREENSBORO, NC 27455-4010
(336) 288-4680
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
5373
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
100000131434
MEDCOST INSURANCE NUMBER
NC
01
—
1067477
NBCOT NUMBER
—
Enumeration date
06/01/2007
Last updated
07/08/2007
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