person
Tyla Davenport
Mental Health Counselor in Vicksburg, Mississippi
NPI 1114575628

Tyla Davenport is a Mental Health Counselor based in Vicksburg, MS and is specialized in Mental Health. Tyla Davenport practices in Vicksburg, MS. The NPI Number for Tyla Davenport is 1114575628 and holds a License No. (Mississippi).

The current practice location address for Tyla Davenport is 3444 Wisconsin Ave, Vicksburg, MS and can be reached out via phone at 601-638-0031.

Location: 3444 Wisconsin Ave, Vicksburg, MS, 39180-5331
person
Provider Profile Details
NPI Number
1114575628
Provider Name
Tyla Davenport
Credential
Provider Entity Type
Individual
Gender
Female
Address
3444 Wisconsin Ave, Vicksburg, MS, 39180-5331
Phone Number
601-638-0031
Fax Number
Provider Enumeration Date
08/28/2019
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
3444 Wisconsin Ave
City
State
Zip
39180-5331
Phone Number
601-638-0031
Fax Number
person
Provider Business Mailing Address Details
Address
3444 Wisconsin Ave
City
State
Zip
39180-5331
Phone Number
601-638-0031
Fax Number
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Mental Health
Taxonomy
License No.
(Mississippi)
Definition
Definition to come...
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