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1003254780
TRACEY DAVENPORT
LOS ANGELES, CA
NPI
1003254780
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date
2013-06-04
Last Update Date
2013-06-04
Business Address
-- TRACEY DAVENPORT
5012 S LA BREA AVE STE 2
LOS ANGELES, CA 90056-1863
Phone number: 323-290-0200
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Mailing Address
-- TRACEY DAVENPORT
5012 S LA BREA AVE STE 2
LOS ANGELES, CA 90056-1863
Phone number: 323-290-0200
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