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Individual

TERRY VANDERGRIFT

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
5245 S I 35 SERVICE RD, OKLAHOMA CITY, OK 73129-7023
(405) 482-9726
Mailing address
7211 MELROSE LN, APT 41, OKLAHOMA CITY, OK 73127-5116
(405) 605-2488

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
171M00000X
Case Manager/Care Coordinator

Other

Enumeration date
03/25/2012
Last updated
05/03/2013
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