Individual
KEYEONNA SHANTA GRAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3621 N KELLEY AVE, SUITE 100, OKLAHOMA CITY, OK 73111-4520
(405) 524-5525
Mailing address
727 S 2ND ST, CHICKASHA, OK 73018-4701
(281) 919-3524
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
04/08/2013
Last updated
04/08/2013
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