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1093158206
KEYEONNA SHANTA GRAY
OKLAHOMA CITY, OK
NPI
1093158206
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date
2013-04-08
Last Update Date
2013-04-08
Business Address
-- KEYEONNA SHANTA GRAY
3621 N KELLEY AVE SUITE 100
OKLAHOMA CITY, OK 73111-4520
Phone number: 405-524-5525
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Mailing Address
-- KEYEONNA SHANTA GRAY
727 S 2ND ST
CHICKASHA, OK 73018-4701
Phone number: 281-919-3524
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