Individual
SHAWNA MAE DAVENPORT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2019 PHEASANT RIDGE DR, WARSAW, IN 46580-5104
(574) 377-4457
Mailing address
2019 PHEASANT RIDGE DR, WARSAW, IN 46580-5104
(574) 377-4457
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
01/27/2025
Last updated
01/27/2025
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