Individual
TIFFANY DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1336 N HARRISON AVE, SHAWNEE, OK 74801-5206
(405) 424-7711
Mailing address
1810 N HARRISON ST APT 210, SHAWNEE, OK 74804-4005
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
—
—
Other
Enumeration date
04/29/2024
Last updated
04/29/2024
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