Provider Demographics
NPI:1851831515
Name:KATHY DAVIS, PLLC
Entity Type:Organization
Organization Name:KATHY DAVIS, PLLC
Other - Org Name:KATHY DAVIS, LPC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:LICENSED PROFESSIONAL COUNSELOR
Authorized Official - Prefix:
Authorized Official - First Name:KATHRYN
Authorized Official - Middle Name:MARGUERITE
Authorized Official - Last Name:DAVIS
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:405-550-2876
Mailing Address - Street 1:5912 W HEFNER RD
Mailing Address - Street 2:#S
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73162-4945
Mailing Address - Country:US
Mailing Address - Phone:405-550-2876
Mailing Address - Fax:405-603-7558
Practice Address - Street 1:5912 W HEFNER RD
Practice Address - Street 2:#S
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73162-4945
Practice Address - Country:US
Practice Address - Phone:405-550-2876
Practice Address - Fax:405-603-7558
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-02-28
Last Update Date:2017-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK3801251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health