Individual
JULIE DAVIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.S.
Contact information
Practice address
2502 CROSSROADS DR, ARDMORE, OK 73401-2503
(580) 226-9388
(580) 226-9395
Mailing address
2021 4TH AVE NW TRLR 90, ARDMORE, OK 73401-2529
(405) 360-2133
(405) 360-2252
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
103TA0400X
Addiction (Substance Use Disorder) Psychologist
UNDER SUPERVISION
—
Other
Enumeration date
05/11/2007
Last updated
08/10/2007
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