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Individual

MR. BRUCE BERNARD DAVIS II

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
4101 NW EXPRESSWAY, APT. 16131, OKLAHOMA CITY, OK 73116-1700
(405) 532-2741
Mailing address
4101 NW EXPRESSWAY, APT. 16131, OKLAHOMA CITY, OK 73116-1700
(405) 532-2741

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
S082321649
OK
Enumeration date
08/28/2009
Last updated
08/28/2009
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