Individual provider · Type 1 NPI

Justus Davenport

Mental Health Counselor · Oklahoma City, OK

NPI number 1053704775 Active

Practice location

6501 Broadway Ext, Suite 180
Oklahoma City, OK 73116-8239

Call (405) 607-4041 Map

Mailing address

18040 NE 10th St
Harrah, OK 73045-8115

Specialties and licenses

TaxonomyCodeLicense
Mental Health Counselor Primary 101YM0800XNone listed

Mental Health Counselor: Definition to come...

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About NPI 1053704775

Justus Davenport's National Provider Identifier is 1053704775, issued on Mar 5, 2015. The primary taxonomy on file is Mental Health Counselor (101YM0800X), and the practice location is in Oklahoma City, OK. The record was last updated on Mar 5, 2015.