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Individual

DEBORAH A GRAY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LPC

Contact information

Practice address
2119 RIVERWALK DR # 218, MOORE, OK 73160-2700
(405) 799-7833
Mailing address
2119 RIVERWALK DR # 218, MOORE, OK 73160-2700
(405) 812-8623

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
101YM0800X
Mental Health Counselor
Primary
4096
OK

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100735950
OK
Enumeration date
05/09/2007
Last updated
10/19/2009
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