Willetta Ruth Grayson, SERVICEPROVIDER
Willetta Ruth Grayson, SERVICEPROVIDER is a Community Health Worker in Idabel, Oklahoma. Practices as a sole proprietor. Licensed in Oklahoma.
- Licensed in
- OK
- In the registry since
- 2009
Practice location Address checks out
Rr 1 Box 686Idabel, OK 74745-9779
Phone: (580) 286-5102
Fax: (580) 286-5929
Show map & directions
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Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Community Health Worker (primary) | Taxonomy 172V00000X · Licence 0810 (OK) |
|---|
Record details
| NPI number | 1619106853 |
|---|---|
| Entity type | Individual (Type 1) |
| Gender | Female |
| Credentials | SERVICEPROVIDER |
| Sole proprietor | Yes |
| NPI enumerated | July 9, 2009 |
| Last updated in NPPES | July 9, 2009 |