Individual
DEMARIO DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1719 SW 11TH ST, LAWTON, OK 73501-7305
(580) 581-1818
Mailing address
1802 NW BELL AVE, LAWTON, OK 73507-6315
(404) 804-2942
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
101YM0800X
Mental Health Counselor
—
—
171000000X
Military Health Care Provider
—
—
171M00000X
Case Manager/Care Coordinator
—
—
Other
Enumeration date
05/23/2023
Last updated
03/17/2025
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