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Individual

HARLI DIJON DAVIS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
3903 N HARRISON ST, SHAWNEE, OK 74804-1426
(405) 585-2971
(405) 585-2983
Mailing address
3903 N HARRISON ST, SHAWNEE, OK 74804-1426
(405) 585-2971
(405) 585-2983

Taxonomy

Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
1329
OK

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1329
LICENSE
OK
Enumeration date
03/31/2021
Last updated
03/31/2021
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