Provider Demographics
NPI:1689092918
Name:GRAY, ANNMARIE (BA, CM II)
Entity Type:Individual
Prefix:
First Name:ANNMARIE
Middle Name:
Last Name:GRAY
Suffix:
Gender:F
Credentials:BA, CM II
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 12978
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73157-2978
Mailing Address - Country:US
Mailing Address - Phone:405-858-2700
Mailing Address - Fax:405-858-2720
Practice Address - Street 1:2617 GENERAL PERSHING BLVD
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73107-6437
Practice Address - Country:US
Practice Address - Phone:405-858-2909
Practice Address - Fax:405-858-2909
Is Sole Proprietor?:No
Enumeration Date:2014-04-03
Last Update Date:2017-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor