Provider Demographics
NPI:1427319136
Name:HOUSE, DAVON R
Entity type:Individual
Prefix:MRS
First Name:DAVON
Middle Name:R
Last Name:HOUSE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2704 INDIAN CREEK BLVD
Mailing Address - Street 2:APT C
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73120-9134
Mailing Address - Country:US
Mailing Address - Phone:405-819-7425
Mailing Address - Fax:
Practice Address - Street 1:2704 INDIAN CREEK BLVD
Practice Address - Street 2:APT C
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73120-9134
Practice Address - Country:US
Practice Address - Phone:405-819-7425
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-30
Last Update Date:2012-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor