Provider Demographics
NPI:1952778110
Name:BARAGREY, ASHLEE
Entity Type:Individual
Prefix:
First Name:ASHLEE
Middle Name:
Last Name:BARAGREY
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 1:309 MOHAWK TRL
Mailing Address - Street 2:
Mailing Address - City:EDMOND
Mailing Address - State:OK
Mailing Address - Zip Code:73003-1310
Mailing Address - Country:US
Mailing Address - Phone:405-761-2552
Mailing Address - Fax:
Practice Address - Street 1:309 MOHAWK TRL
Practice Address - Street 2:
Practice Address - City:EDMOND
Practice Address - State:OK
Practice Address - Zip Code:73003-1310
Practice Address - Country:US
Practice Address - Phone:405-761-2552
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-08-24
Last Update Date:2021-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OKALD2099133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered