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1508264482
ERIC DAVENPORT
IDAHO FALLS, ID
NPI
1508264482
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
101YM0800X Counselor Mental Health
(Licence: ID LMSW-34320)
Enumeration Date
2014-12-09
Last Update Date
2014-12-09
Business Address
ERIC DAVENPORT LMSW
2267 TETON PLZ
IDAHO FALLS, ID 83404-6486
Phone number: 208-524-4953
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Mailing Address
ERIC DAVENPORT LMSW
2267 TETON PLZ
IDAHO FALLS, ID 83404-6486
Phone number: 208-524-4953
Copy
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