Provider Demographics
NPI:1013186774
Name:GAFFORD, BECKY ANN
Entity Type:Individual
Prefix:
First Name:BECKY
Middle Name:ANN
Last Name:GAFFORD
Suffix:
Gender:F
Credentials:
Other - Prefix:MS
Other - First Name:REBECCA
Other - Middle Name:ANN
Other - Last Name:GAFFORD
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:423 W WILL ROGERS BLVD
Mailing Address - Street 2:
Mailing Address - City:CLAREMORE
Mailing Address - State:OK
Mailing Address - Zip Code:74017-6820
Mailing Address - Country:US
Mailing Address - Phone:918-810-8929
Mailing Address - Fax:
Practice Address - Street 1:423 W WILL ROGERS BLVD
Practice Address - Street 2:
Practice Address - City:CLAREMORE
Practice Address - State:OK
Practice Address - Zip Code:74017-6820
Practice Address - Country:US
Practice Address - Phone:918-810-8929
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-02-27
Last Update Date:2009-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor