Provider Demographics
NPI:1417559220
Name:DAVENPORT, ABBY (OTR/L)
Entity Type:Individual
Prefix:
First Name:ABBY
Middle Name:
Last Name:DAVENPORT
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:ABBY
Other - Middle Name:
Other - Last Name:LOEWENSTEIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OTR/L
Mailing Address - Street 1:3226 SHAWNEE TRL
Mailing Address - Street 2:
Mailing Address - City:PINCKNEY
Mailing Address - State:MI
Mailing Address - Zip Code:48169-9311
Mailing Address - Country:US
Mailing Address - Phone:248-514-5166
Mailing Address - Fax:
Practice Address - Street 1:3226 SHAWNEE TRL
Practice Address - Street 2:
Practice Address - City:PINCKNEY
Practice Address - State:MI
Practice Address - Zip Code:48169-9311
Practice Address - Country:US
Practice Address - Phone:248-514-5166
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-11-16
Last Update Date:2020-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0006480225XG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XG0600XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGerontology