Provider Information for 1295856110
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DAVINA KAVANAUGH LLPC
Sex: Female
NPI: 1295856110
Last Updated: 2009-10-28
Certification Date:
Certification Date:
Details
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NPI | 1295856110 | ||||||||
Enumeration Date | 2007-04-02 | ||||||||
NPI Type | NPI-1 Individual | ||||||||
Sole Proprietor | YES | ||||||||
Status | Active | ||||||||
Mailing Address | 3718 OLNEY RD KALAMAZOO, MI 49006-2863 United States Phone: 269-344-0747 | Fax:269-226-0748 | ||||||||
Primary Practice Address | 148 N RIVERVIEW DR PARCHMENT, MI 49004-1308 United States Phone: 269-344-0747 | Fax:269-226-0748 | ||||||||
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