| NPI | 1043332778 |
|---|---|
| Former Legal Business Name | DR SUSAN F DAVENPORT |
| Entity Type | Organization |
| Authorized Contact | SUSAN F DAVENPORT Owner 478-922-2365 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: GA 1969) |
| Enumeration Date | 2007-04-04 |
| Last Update Date | 2020-08-22 |