| Provider / Organization | NPI | Date Certified |
|---|---|---|
| MARIQUENA EDITH DAVENPORT | 1427520105 | 2023-05-06 |
Mariquena Edith Davenport is registered with the National Plan and Provider Enumeration System and has been issued an National Provider Identifier (NPI) of 1427520105. Registration indicates Mariquena Edith Davenport is a provider of services with a specialization in Behavioral Health & Social Service Providers, Behavior Technician (Behavior Technician, Behavioral Health & Social Service Providers) (Behavior Technician, ) Access to Mental Health/Behavioral Health Providers (Behavioral Health & Social Service Providers, Social Worker) (Behavioral Health & Social Service Providers, Social Worker) (Social Worker: Clinical, ) (Behavioral Health/Substance Abuse/Psychiatry, ) (Social Worker Clinical, Behavioral Health & Social Service Providers) (Social Worker, )
| Entity Type | Individual |
| Provider Name | Mariquena Edith Davenport LCSWA |
| Practice Office Address | 154 MCIVER ST SANFORD, NC US |
| Practice Office Telephone | 9192535396 |
| Mailing Address | 154 MCIVER ST SANFORD, NC 273304305 US |
| Business Telephone | 9192535396 |
| Address | City / State | Phone / Fax |
|---|---|---|
| 11 Union St S Ste 206 | Concord, NC 280251004 | 7049189741 |
| Code | Practice | License No State |
|---|---|---|
| 106S00000X | Behavioral Health & Social Service Providers Behavior Technician Behavior Technician Behavioral Health & Social Service Providers Behavior Technician | |
| 1041C0700X PRIMARY | Access to Mental Health/Behavioral Health Providers Behavioral Health & Social Service Providers Social Worker Behavioral Health & Social Service Providers Social Worker Social Worker: Clinical Behavioral Health/Substance Abuse/Psychiatry Social Worker Clinical Behavioral Health & Social Service Providers Social Worker | P017203
NC |