Individual
AMBER DAVIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
211 E JACKSON ST, HUGO, OK 74743-4036
(580) 326-5279
Mailing address
211 E JACKSON ST, HUGO, OK 74743-4036
(580) 326-5279
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200493040
—
OK
05
—
200493040A
—
OK
Enumeration date
08/19/2013
Last updated
08/19/2013
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