| Shana Netherlain Davis | |
|
1624 Clayton Dr Tahlequah OK 74464-8004 | |
| (918) 864-1013 | |
| Not Available |
| Full Name | Shana Netherlain Davis |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 1624 Clayton Dr, Tahlequah, Oklahoma |
| Authorized Official Name and Position | Shana Netherlain Davis (BHRS) |
| Authorized Official Contact | 9188641013 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Shana Netherlain Davis 1624 Clayton Dr Tahlequah OK 74464-8004 Ph: (918) 864-1013 | Shana Netherlain Davis 1624 Clayton Dr Tahlequah OK 74464-8004 Ph: (918) 864-1013 |
| NPI Number | 1861768384 |
|---|---|
| Provider Enumeration Date | 03/29/2012 |
| Last Update Date | 03/29/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1861768384 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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