MITCHELL K DAVENPORT

ROCKFORD, IL
NPI1750461646
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy101YM0800X Counselor, Mental Health
(Licence:   180003775)
Enumeration Date2006-10-16
Last Update Date2007-07-08
Business Address
-- MITCHELL K DAVENPORT LCPC
526 W STATE STREET
ROCKFORD, IL 61101-1214
Phone number: 815-968-9300
Mailing Address
-- MITCHELL K DAVENPORT LCPC
526 W STATE STREET
ROCKFORD, IL 61101-1214
Phone number: 815-968-9300
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