NPI | 1447307319 |
---|---|
Former Name | LANAD DAVENPORT |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: KY 42000) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
Enumeration Date | 2007-01-04 |
Last Update Date | 2018-05-07 |