Davenport, Susan F
Davenport, Susan F is an sole proprietor health care provider with primary practice located at 121 Carl Vinson Parkway , Warner Robins GA 31088. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as her primary health care specialty. Davenport, Susan F can be contacted via phone (478) 922-2365.Contact Information
Primary practice address
121 Carl Vinson Parkway
Warner Robins GA 31088
Phone: (478) 922-2365
Fax: (478) 922-1778
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Clinical | 103TC0700X | 1969 | Georgia |
Profile Details
| NPI number | 1760447585 |
|---|---|
| LBN Legal business name | Davenport, Susan F |
| Credentials | PHD |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Apr 18th, 2006 |
| Last updated | Aug 16th, 2010 - about 16 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1760447585 | NPPES |
| Other | 572913 | BCBS | |
| MEDICAID | 000693448A | BCBS |
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