| NPI | 1063797504 |
|---|---|
| Doing Business As | DAVENPORT PSYCHOLOGY |
| Entity Type | Organization |
| Authorized Contact | CHARLES ROBERT DAVENPORT Managing Member 941-321-1971 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: FL PY7978) |
| Additional Taxonomies | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: FL PY7978) |
| 103TF0000X Psychologist, Family (Licence: FL PY7978) | |
| Enumeration Date | 2011-10-16 |
| Last Update Date | 2021-06-10 |