Individual
KATHY LYNN DAVIES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MED
Contact information
Practice address
2104-A N BROADWAY ST, POTEAU, OK 74953-2617
(918) 647-0485
Mailing address
2104 N BROADWAY ST UNIT A, POTEAU, OK 74953-2538
(918) 647-0485
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
197338
OK
101YP2500X
Professional Counselor
5767
OK
Other
Enumeration date
04/04/2011
Last updated
10/21/2015
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