NPI | 1962542654 |
---|---|
Former Name | SARA N DAVENPORT |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: KY KY-1139) |
Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: KY KY-0508) |
Enumeration Date | 2007-02-08 |
Last Update Date | 2010-02-09 |