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Individual

LACEY DAVIS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LPC-S

Contact information

Practice address
4800 E I 240 SERVICE RD APT 1111, OKLAHOMA CITY, OK 73135-2629
(140) 540-1974
Mailing address
4800 E I 240 SERVICE RD APT 1111, OKLAHOMA CITY, OK 73135-2629
(140) 540-1974

Taxonomy

Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
7220
OK

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
200551560
OK
Enumeration date
06/06/2014
Last updated
08/30/2022
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