Provider Demographics
NPI:1003422544
Name:GREGORY, WHITNEY SEANEE
Entity Type:Individual
Prefix:
First Name:WHITNEY
Middle Name:SEANEE
Last Name:GREGORY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4901 N COLLEGE AVE
Mailing Address - Street 2:
Mailing Address - City:BETHANY
Mailing Address - State:OK
Mailing Address - Zip Code:73008-2652
Mailing Address - Country:US
Mailing Address - Phone:405-370-1105
Mailing Address - Fax:
Practice Address - Street 1:4901 N COLLEGE AVE
Practice Address - Street 2:
Practice Address - City:BETHANY
Practice Address - State:OK
Practice Address - Zip Code:73008-2652
Practice Address - Country:US
Practice Address - Phone:405-370-1105
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-21
Last Update Date:2020-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator