Individual
ASHLEY R DAVIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
10840 WISTERIA LN, KINGSTON, OK 73439-9188
(580) 565-0766
Mailing address
PO BOX 704, KINGSTON, OK 73439-0704
(580) 565-0766
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
04/24/2012
Last updated
04/24/2012
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