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1194085282
MONTGOMERY S DAVENPORT
SAN DIEGO, CA
NPI
1194085282
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101Y00000X Counselor
Additional Taxonomies
101YM0800X Counselor, Mental Health
(Licence: MI 6401011388)
Enumeration Date
2012-05-22
Last Update Date
2015-07-08
Business Address
-- MONTGOMERY S DAVENPORT LPC
3132 JEFFERSON ST
SAN DIEGO, CA 92110-4421
Phone number: 619-683-3100
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Mailing Address
-- MONTGOMERY S DAVENPORT LPC
3132 JEFFERSON ST
SAN DIEGO, CA 92110-4421
Phone number: 619-683-3100
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