Individual
DR. ELIZABETH MOLLETTE GRUNDY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
1520 NORTH INDUSTRIAL ROAD, VINITA, OK 74301
(918) 629-8664
(918) 782-4301
Mailing address
PO BOX 426, VINITA, OK 74301-0426
(918) 629-8664
(918) 782-4301
Taxonomy
Speciality
Code
Description
License number
State
103TH0100X
Health Service Psychologist
Primary
750
OK
Other
Enumeration date
10/23/2006
Last updated
07/08/2007
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