Individual provider · Type 1 NPI
Candida Amber Davenport, LAC, LADC
Addiction (Substance Use Disorder) Counselor · Plymouth, MN
NPI number
1932138765
Active
Practice location
115 Forestview Ln N
Plymouth, MN 55441-5910
Fax (763) 546-7674
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 1492 (ND) |
| Addiction (Substance Use Disorder) Counselor Primary | 101YA0400X | 303356 (MN) |
Addiction (Substance Use Disorder) Counselor: Definition to come...
Another provider at this address
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About NPI 1932138765
Candida Amber Davenport, LAC, LADC's National Provider Identifier is 1932138765, issued on Jul 2, 2006. The primary taxonomy on file is Addiction (Substance Use Disorder) Counselor (101YA0400X), and the practice location is in Plymouth, MN. The record was last updated on Jun 24, 2013.