Davenport, Jodie
Davenport, Jodie is an individual health care provider with primary practice located at 1701 Aldersgate Rd Ste 1 , Little Rock AR 72205-6675. She recently has only one registered license in Behavioral Health & Social Service Providers / Behavioral Analyst, which is considered as her primary health care specialty. Davenport, Jodie can be contacted via phone (501) 389-8390.Contact Information
Primary practice address
1701 Aldersgate Rd Ste 1
Little Rock AR 72205-6675
Phone: (501) 389-8390
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Behavioral Analyst | 103K00000X | 1-10-7346 |
Profile Details
| NPI number | 1972806164 |
|---|---|
| LBN Legal business name | Davenport, Jodie |
| Credentials | BCBA |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Dec 10th, 2010 |
| Last updated | Apr 17th, 2023 - about 2 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1972806164 | NPPES |
| Florida | MEDICAID | 102622700 |
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