Doctor Name: | BETTINA NICOLE DAVIS |
NPI Number: | 1306008420 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | M.S. CCC-SLP |
License Number: | 3424 |
Business Practice Address: | 7112 S Mingo Rd Ste 108 Tulsa, OK - 741333267 |
Business Phone Number: | -182507093 |
Business Fax Number: | 9182509976 |
Mailing Address: | 7112 S Mingo Rd Ste 108, TULSA |
State: | OK |
Postal Code: | 741333267 |
Phone Number: | -182507093 |
Fax Number: | 9182509976 |
NPI Enumeration Date: | 06/30/2008 |
NPI Last Update Date: | 06/30/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | 3424 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | OK |
Taxonomy Type: | Speech, Language and Hearing Service Providers |
Taxonomy Classification: | Speech-Language Pathologist |
Taxonomy Specialization: | |
Taxonomy Definition: | A speech pathologist is a person qualified by a master |