Angela Dorene Gray, LSWA-P, CDSVRP

Individual provider Active NPI Case Manager/Care Coordinator · Coalgate, OK

NPI 1447950688 · NPPES record last updated Mar 7, 2023

Key facts

NPI
1447950688
Entity type
Individual (NPI type 1)
Primary specialty
Case Manager/Care Coordinator 171M00000X
Practice address
15845 State Highway 31
Coalgate, OK 74538-3865
Phone
(580) 579-1328
NPI assigned
Mar 7, 2023
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Case Manager/Care Coordinator 171M00000X Yes

Addresses

Primary practice location

15845 State Highway 31
Coalgate, OK 74538-3865

Mailing address

15845 State Highway 31
Coalgate, OK 74538-3865

Other providers in Coalgate, OK

All providers in Coalgate, OK · Case Manager/Care Coordinator in Oklahoma

Sources for this page

Verify at the official NPI Registry.