Individual
MELISSA GRAGG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.ED. LPC
Contact information
Practice address
7908 NW 23RD ST, BETHANY, OK 73008
(405) 487-8623
Mailing address
7908 NW 23RD ST, BETHANY, OK 73008-4950
(405) 487-8623
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
6853
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
225C00000X
22 RESPIRATORY, DEVELOPMENTAL, REHABILITATIVE ETC...
OK
Enumeration date
03/11/2013
Last updated
06/18/2018
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