ROGER D. GRAY

ADA, OK
NPI1194972455
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: OK  112)
Enumeration Date2008-08-19
Last Update Date2008-08-19
Business Address
Mr. ROGER D. GRAY LADC
605 E 12TH ST
ADA, OK 74820-6605
Phone number: 580-436-3504
Mailing Address
Mr. ROGER D. GRAY LADC
PO BOX 2274
ADA, OK 74821-2274
Phone number: 580-436-3504