Individual
KATIE NICOLE DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
404 E WATOVA ST, TALALA, OK 74080-9542
(719) 280-7853
Mailing address
404 E WATOVA ST, TALALA, OK 74080-9542
(719) 280-7853
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
—
OK
Other
Enumeration date
11/06/2024
Last updated
11/27/2024
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