Provider Demographics
NPI:1497394142
Name:DAVENPORT-MONTGOMERY, NAKIIA
Entity Type:Individual
Prefix:
First Name:NAKIIA
Middle Name:
Last Name:DAVENPORT-MONTGOMERY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2025 CORAL IVY LN
Mailing Address - Street 2:
Mailing Address - City:CHESAPEAKE
Mailing Address - State:VA
Mailing Address - Zip Code:23323-6372
Mailing Address - Country:US
Mailing Address - Phone:240-527-0178
Mailing Address - Fax:
Practice Address - Street 1:2025 CORAL IVY LN
Practice Address - Street 2:
Practice Address - City:CHESAPEAKE
Practice Address - State:VA
Practice Address - Zip Code:23323-6372
Practice Address - Country:US
Practice Address - Phone:240-527-0178
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-12-29
Last Update Date:2019-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor