CANDIDA AMBER DAVENPORT

PLYMOUTH, MN
NPI1932138765
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: MN  303356)
Additional Taxonomies101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: ND  1492)
Enumeration Date2006-07-02
Last Update Date2013-06-24
Business Address
Mrs. CANDIDA AMBER DAVENPORT LAC, LADC
115 FORESTVIEW LN N
PLYMOUTH, MN 55441-5910
Phone number: 763-546-8008
Mailing Address
Mrs. CANDIDA AMBER DAVENPORT LAC, LADC
115 FORESTVIEW LN N
PLYMOUTH, MN 55441-5910
Phone number: 763-546-8008