Individual
DAVIONE ELLISON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2442 MOHAWK BLVD, TULSA, OK 74110-1519
(918) 430-0597
(918) 430-0995
Mailing address
4713 E 80TH ST APT 8C, TULSA, OK 74136-8951
(682) 241-6967
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
04/25/2022
Last updated
04/25/2022
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