Individual
MR. RAY TAINPEAH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2307 S GORDON COOPER DR, SHAWNEE, OK 74801-9007
(405) 273-5236
Mailing address
PO BOX 417, PRAGUE, OK 74864-0417
(405) 395-7398
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
472
OK
Other
Enumeration date
06/01/2007
Last updated
07/08/2007
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