Individual
BETTINA NICOLE DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.S. CCC-SLP
Contact information
Practice address
7112 S MINGO RD STE 108, TULSA, OK 74133-3267
182507093
(918) 250-9976
Mailing address
7112 S MINGO RD STE 108, TULSA, OK 74133-3267
182507093
(918) 250-9976
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
3424
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
TO BE ASSIGNED
—
OK
Enumeration date
06/30/2008
Last updated
07/21/2022
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