MEDICARE: CHERYL V DAVENPORT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	106S00000X	Behavior Technician		AZ

General Provider Information

NPI Number	:	1760370142
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHERYL V DAVENPORT

Provider Business Mailing Address
First Line	:	PO BOX 765114
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75376-5114
Country	:	US
Telephone Number	:	214-308-8265
Fax Number	:

Provider Business Practice Location Address
First Line	:	7575 S WESTMORELAND RD APT 2233
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75237-3387
Country	:	US
Telephone Number	:	214-308-8265
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/25/2025
Last Update Date	:	06/25/2025

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Directions to “ CHERYL V DAVENPORT ” Practice Location

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