Provider Demographics
NPI:1609149376
Name:GRAY, NOEL MARIE (MDIV)
Entity Type:Individual
Prefix:MS
First Name:NOEL
Middle Name:MARIE
Last Name:GRAY
Suffix:
Gender:F
Credentials:MDIV
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12400 WHISPER GLEN DR
Mailing Address - Street 2:
Mailing Address - City:EDMOND
Mailing Address - State:OK
Mailing Address - Zip Code:73034-2177
Mailing Address - Country:US
Mailing Address - Phone:405-606-5824
Mailing Address - Fax:405-282-9004
Practice Address - Street 1:12400 WHISPER GLEN DR
Practice Address - Street 2:
Practice Address - City:EDMOND
Practice Address - State:OK
Practice Address - Zip Code:73034-2177
Practice Address - Country:US
Practice Address - Phone:405-606-5824
Practice Address - Fax:405-282-9004
Is Sole Proprietor?:Yes
Enumeration Date:2012-02-10
Last Update Date:2012-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst