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1053704775
JUSTUS DAVENPORT
OKLAHOMA CITY, OK
NPI
1053704775
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
101YM0800X Counselor, Mental Health
Enumeration Date
2015-03-05
Last Update Date
2015-03-05
Business Address
-- JUSTUS DAVENPORT
6501 BROADWAY EXT SUITE 180
OKLAHOMA CITY, OK 73116-8239
Phone number: 405-607-4041
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Mailing Address
-- JUSTUS DAVENPORT
18040 NE 10TH ST
HARRAH, OK 73045-8115
Phone number:
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