Provider Demographics
NPI:1285867879
Name:DAVENPORT, BECKY R (PHD, LMFT)
Entity Type:Individual
Prefix:DR
First Name:BECKY
Middle Name:R
Last Name:DAVENPORT
Suffix:
Gender:F
Credentials:PHD, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21015 MARKET RIDGE
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78258-4975
Mailing Address - Country:US
Mailing Address - Phone:210-496-0100
Mailing Address - Fax:210-496-0101
Practice Address - Street 1:21015 MARKET RIDGE
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78258-4975
Practice Address - Country:US
Practice Address - Phone:210-496-0100
Practice Address - Fax:210-496-0101
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-28
Last Update Date:2022-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXLMFT201192106H00000X
TX201192106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist