Individual
DR. GRADY LLOYD BLACKWOOD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
3037 NW 63RD ST, #255, OKLAHOMA CITY, OK 73116-3637
(405) 843-8026
Mailing address
3037 NW 63RD ST, #255, OKLAHOMA CITY, OK 73116-3637
(405) 843-8026
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
263
OK
Other
Enumeration date
01/16/2007
Last updated
04/16/2012
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