Provider Demographics
NPI:1205138096
Name:DAVENPORT, PHOEBE (OTR/L)
Entity type:Individual
Prefix:
First Name:PHOEBE
Middle Name:
Last Name:DAVENPORT
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5 HOOK MILL RD
Mailing Address - Street 2:
Mailing Address - City:MADBURY
Mailing Address - State:NH
Mailing Address - Zip Code:03823-7540
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:795 WASHINGTON RD
Practice Address - Street 2:
Practice Address - City:RYE
Practice Address - State:NH
Practice Address - Zip Code:03870-2318
Practice Address - Country:US
Practice Address - Phone:603-964-8144
Practice Address - Fax:603-964-1683
Is Sole Proprietor?:No
Enumeration Date:2010-11-30
Last Update Date:2015-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH2009225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist