ERIC DAVENPORT

IDAHO FALLS, ID
NPI1508264482
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy101YM0800X Counselor, Mental Health
(Licence: ID  LMSW-34320)
Enumeration Date2014-12-09
Last Update Date2014-12-09
Business Address
-- ERIC DAVENPORT LMSW
2267 TETON PLZ
IDAHO FALLS, ID 83404-6486
Phone number: 208-524-4953
Mailing Address
-- ERIC DAVENPORT LMSW
2267 TETON PLZ
IDAHO FALLS, ID 83404-6486
Phone number: 208-524-4953
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