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Clancy Davis
Peer Specialist in Ada, Oklahoma
NPI 1023488392

Clancy Davis is a Peer Specialist based in Ada, OK. Clancy Davis practices in Ada, OK. The NPI Number for Clancy Davis is 1023488392 and holds a License No. (Oklahoma).

The current practice location address for Clancy Davis is 124 South Broadway, Ada, OK and can be reached out via phone at 580-332-3001 and via fax at 580-332-8774.

Location: 124 South Broadway, Ada, OK, 74820-0000
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1023488392
Provider Name
Clancy Davis
Credential
Provider Entity Type
Individual
Gender
Male
Address
124 South Broadway, Ada, OK, 74820-0000
Phone Number
580-332-3001
Fax Number
580-332-8774
Provider Enumeration Date
09/30/2015
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
124 South Broadway
City
Ada
State
Oklahoma
Zip
74820-0000
Phone Number
580-332-3001
Fax Number
580-332-8774
person
Provider Business Mailing Address Details
Address
124 South Broadway
City
Ada
State
Oklahoma
Zip
74820-0000
Phone Number
580-332-3001
Fax Number
580-332-8774
person
Provider's Taxonomy Details 1
Type
Other Service Providers
Classification
Peer Specialist
Speciality
-
Taxonomy
175T00000X
License No.
()
Definition
Individuals certified to perform peer support services through a training process defined by a government agency, such as the Department of Veterans Affairs or a state mental health department/certification/licensing authority.
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