Individual provider · Type 1 NPI

Tyla Davenport

Mental Health Counselor · Vicksburg, MS

NPI number 1114575628 Active

Practice location

3444 Wisconsin Ave
Vicksburg, MS 39180-5331

Specialties and licenses

TaxonomyCodeLicense
Mental Health Counselor Primary 101YM0800XNone listed

Mental Health Counselor: Definition to come...

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About NPI 1114575628

Tyla Davenport's National Provider Identifier is 1114575628, issued on Aug 28, 2019. The primary taxonomy on file is Mental Health Counselor (101YM0800X), and the practice location is in Vicksburg, MS. The record was last updated on Aug 28, 2019.