Doctor Name: | MR. LOUIS G GRAY |
NPI Number: | 1366707481 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | |
License Number: | |
Business Practice Address: | 1011 Grandview Pawhuska, OK - 74056 |
Business Phone Number: | 9182875415 |
Business Fax Number: | |
Mailing Address: | 137 Ramblewood Rd, BARTLESVILLE |
State: | OK |
Postal Code: | 740031638 |
Phone Number: | 9183364073 |
Fax Number: | |
NPI Enumeration Date: | 07/05/2012 |
NPI Last Update Date: | 07/05/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YA0400X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Addiction (Substance Use Disorder) |
Taxonomy Definition: |