Individual
MR. SHAUN ROBERT GRANGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
429 N UNION AVE, SHAWNEE, OK 74801-7019
(405) 275-1844
(405) 275-1124
Mailing address
1906 RAIN TREE DR, SHAWNEE, OK 74804-4426
(405) 210-8245
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
—
—
Other
Enumeration date
04/07/2020
Last updated
04/07/2020
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