Individual
JESSICA GRANT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
312 NE 28TH ST, SUITE 101, OKLAHOMA CITY, OK 73105-2804
(405) 231-3150
Mailing address
312 NE 28TH ST, SUITE 101, OKLAHOMA CITY, OK 73105-2804
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
OK
Other
Enumeration date
04/30/2013
Last updated
04/30/2013
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