Individual
AMANDA DAVENPORT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
L.C.S.W.
Contact information
Practice address
102 MAIN ST, SUITE 217, LAGRANGE, GA 30240-3225
(706) 668-5035
(706) 243-4939
Mailing address
102 MAIN ST, SUITE 217, LAGRANGE, GA 30240-3225
(706) 668-5035
(706) 243-4939
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
CSW005606
GA
Other
Enumeration date
02/20/2017
Last updated
02/20/2017
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