Provider Demographics
NPI:1497878425
Name:GRIGSBY, REBECCA K (CRSS)
Entity Type:Individual
Prefix:MS
First Name:REBECCA
Middle Name:K
Last Name:GRIGSBY
Suffix:
Gender:F
Credentials:CRSS
Other - Prefix:MS
Other - First Name:BECKY
Other - Middle Name:K
Other - Last Name:GRIGSBY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:CRSS
Mailing Address - Street 1:12112 WILLOW WAY
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73162-1025
Mailing Address - Country:US
Mailing Address - Phone:405-227-9422
Mailing Address - Fax:
Practice Address - Street 1:909 ALAMEDA ST
Practice Address - Street 2:
Practice Address - City:NORMAN
Practice Address - State:OK
Practice Address - Zip Code:73071-5229
Practice Address - Country:US
Practice Address - Phone:405-573-3987
Practice Address - Fax:405-573-8245
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator