Most Relevant Information
Provider Data
| NPI Number: | 1003254780 |
| Provider Name: | TRACEY DAVENPORT |
| Entity Type: | Individual |
| Taxonomy Code: | 101YA0400X |
| Specialty: | Counselor |
| License Number: |
Most Important Dates
| Enumeration Date: | 06/04/2013 |
| Last Updated: | 06/04/2013 |
Provider Practice Location
5012 S LA BREA AVE STE 2
LOS ANGELES
CA
900561863
Practice Location Phone/Fax
| Phone: | 3232900200 |
| Fax: | 3232900202 |
Provider Mailing Location
5012 S LA BREA AVE STE 2
LOS ANGELES
CA
900561863
Provider Mailing Phone/Fax
| Phone: | 3232900200 |
| Fax: | 3232900202 |