Individual provider · Type 1 NPI
Bruce Davenport
Professional Counselor · Jefferson City, TN
NPI number
1790552255
Active
Practice location
1820 Paul Dr
Jefferson City, TN 37760-5229
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Professional Counselor Primary | 101YP2500X | LPC0000000729 (TN) |
Professional Counselor: Definition to come...
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About NPI 1790552255
Bruce Davenport's National Provider Identifier is 1790552255, issued on Dec 5, 2023. The primary taxonomy on file is Professional Counselor (101YP2500X), and the practice location is in Jefferson City, TN. The record was last updated on Dec 5, 2023.