Individual
GENTRY DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1211 MAGNOLIA CT, MOORE, OK 73160-1397
(419) 318-2300
Mailing address
9307 S SHARTEL AVE APT 101, OKLAHOMA CITY, OK 73139-5210
(405) 740-1876
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
08/20/2024
Last updated
08/20/2024
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