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General NPI Number Information
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NPI Number | 1831434653
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Entity Type | Individual
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Provider Name | KIRSTEN LIL'VON CAMPBELL-DAVENPORT BA PSYCHOLOGY
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Gender | Female
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Dates
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Enumeration Date | 12/05/2012
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Last Update Date | 12/11/2024
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Provider Practice Location Address
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Address Line | 1777 S BURLINGTON BLVD UNIT 271
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City | BURLINGTON
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State | WA
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Zip | 98233-3223
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Country | US
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Telephone | 360-503-3815
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Fax |
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Provider Business Mailing Address
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Address Line | 1720 E COLLEGE AVE APT 45
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City | GUTHRIE
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State | OK
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Zip | 73044-4542
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Country | US
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Telephone | 918-206-3953
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 374J00000X
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Taxonomy Name | Doula
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License Number | BD61609590
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License Number State | WA
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