Individual
SHELBI JUAN ICE DAVIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2402 ROBIN RDG, ENID, OK 73703-6419
(580) 366-9799
Mailing address
2402 ROBIN RDG, ENID, OK 73703-6419
(590) 366-9799
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
08/25/2022
Last updated
08/25/2022
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