Individual
SHANNON RACHELLE GREGORY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
115 S MAIN ST, MIAMI, OK 74354-7024
(918) 544-6424
Mailing address
115 S MAIN ST, MIAMI, OK 74354-7024
(918) 544-6424
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
—
OK
Other
Enumeration date
12/03/2025
Last updated
12/03/2025
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