Individual
ANGELA DORENE GRAY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LSWA-P, CDSVRP
Contact information
Practice address
15845 STATE HIGHWAY 31, COALGATE, OK 74538-3865
(580) 579-1328
Mailing address
15845 STATE HIGHWAY 31, COALGATE, OK 74538-3865
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
03/07/2023
Last updated
03/07/2023
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