Individual
SUSAN ELIZABETH DAVIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
6202 S LEWIS AVE STE J, TULSA, OK 74136-1064
(918) 392-7988
Mailing address
PO BOX 1289, GLENPOOL, OK 74033-1289
(678) 588-7789
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
MSW003837
GA
1041C0700X
Clinical Social Worker
Primary
6720
OK
1041C0700X
Clinical Social Worker
CSW005544
GA
Other
Enumeration date
09/21/2007
Last updated
01/20/2023
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