Individual
BRENDA DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.ED, CCC-SLP
Contact information
Practice address
8524 S WESTERN AVE, SUITE 112, OKLAHOMA CITY, OK 73139-9246
(405) 640-7045
(405) 702-9397
Mailing address
PO BOX 7753, MOORE, OK 73153-1753
(405) 640-7045
(405) 702-9397
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
2755
OK
Other
Enumeration date
12/04/2009
Last updated
12/04/2009
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