Healthcare Provider Details

I. General information

NPI: 1619212776
Provider Name (Legal Business Name): GINGER KAY DAVIS LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/30/2012
Last Update Date: 03/17/2022
Certification Date: 03/17/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6475 36TH AVE NW APT 228
NORMAN OK
73072-1306
US

IV. Provider business mailing address

7050 AIR DEPOT BLVD BLDG 1094
TINKER AFB OK
73145-8716
US

V. Phone/Fax

Practice location:
  • Phone: 469-383-2273
  • Fax:
Mailing address:
  • Phone: 405-582-6603
  • Fax: 972-551-8359

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number6664
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: