Provider Information for 1215574611
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TEVIN D DAVIS LPC
Sex: Male
NPI: 1215574611
Last Updated: 2024-04-23
Certification Date: 2024-04-23
Certification Date: 2024-04-23
Details
| Name | Value | ||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| NPI | 1215574611 | ||||||||||||
| Enumeration Date | 2019-12-04 | ||||||||||||
| NPI Type | NPI-1 Individual | ||||||||||||
| Sole Proprietor | YES | ||||||||||||
| Status | Active | ||||||||||||
| Mailing Address | 650 S PEORIA AVE TULSA, OK 74120-4429 United States Phone: 918-978-1880 | Fax: | ||||||||||||
| Primary Practice Address | 5061 S 136TH EAST AVE APT 311 TULSA, OK 74134-7015 United States Phone: 918-978-1880 | Fax: | ||||||||||||
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