Provider Demographics
NPI:1467734186
Name:DAVIS, PAULA KAY (OTR/L)
Entity Type:Individual
Prefix:MRS
First Name:PAULA
Middle Name:KAY
Last Name:DAVIS
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8104 HAWKSBURY RD
Mailing Address - Street 2:
Mailing Address - City:YUKON
Mailing Address - State:OK
Mailing Address - Zip Code:73099-8828
Mailing Address - Country:US
Mailing Address - Phone:405-603-8886
Mailing Address - Fax:
Practice Address - Street 1:8104 HAWKSBURY RD
Practice Address - Street 2:
Practice Address - City:YUKON
Practice Address - State:OK
Practice Address - Zip Code:73099-8828
Practice Address - Country:US
Practice Address - Phone:405-603-8886
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-09-20
Last Update Date:2011-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OKOT506174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist