Individual
DEBRA DAVIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
BA
Contact information
Practice address
1606 E DOWNING, TAHLEQUAH, OK 74464
(918) 453-1217
Mailing address
205 S JT STITES, SALLISAW, OK 74955
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
10/19/2011
Last updated
10/19/2011
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