Individual
MRS. LACRESHA DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
317 SW C AVE, LAWTON, OK 73501-4016
(580) 357-6141
Mailing address
317 SW C AVE, LAWTON, OK 73501-4016
(580) 250-1123
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
320211
OK
175T00000X
Peer Specialist
Primary
131080
OK
Other
Enumeration date
01/14/2019
Last updated
12/03/2025
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