Provider Demographics
NPI:1619337557
Name:DAVENPORT, TONI (MA, CART)
Entity Type:Individual
Prefix:
First Name:TONI
Middle Name:
Last Name:DAVENPORT
Suffix:
Gender:F
Credentials:MA, CART
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10101 FONDREN RD
Mailing Address - Street 2:STE. 240
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77096-4564
Mailing Address - Country:US
Mailing Address - Phone:713-774-5216
Mailing Address - Fax:713-774-2307
Practice Address - Street 1:10101 FONDREN RD
Practice Address - Street 2:STE. 240
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77096-4564
Practice Address - Country:US
Practice Address - Phone:713-774-5216
Practice Address - Fax:713-774-2307
Is Sole Proprietor?:Yes
Enumeration Date:2016-03-04
Last Update Date:2016-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor