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1497505606
MICHEAL DAVENPORT-MATHIS
DOUGLASVILLE, GA
NPI
1497505606
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
106S00000X Behavior Technician
Enumeration Date
2024-03-22
Last Update Date
2024-03-22
Business Address
MICHEAL DAVENPORT-MATHIS
3294 SR-5 N
DOUGLASVILLE, GA 30135
Phone number: 857-829-4040
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Mailing Address
MICHEAL DAVENPORT-MATHIS
800 W MARIETTA ST NW
ATLANTA, GA 30318-5214
Phone number: 267-633-5052
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