Individual
CHRISTOPHER DEWAYNE GRANT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
807 NE 21ST ST, OKLAHOMA CITY, OK 73105-8213
(318) 290-9714
Mailing address
807 NE 21ST ST, OKLAHOMA CITY, OK 73105-8213
(318) 290-9714
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
R082463502
OK
Other
Enumeration date
01/21/2018
Last updated
01/21/2018
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