Itha Joyce Gray, ICADC

NPI #1043420227 in Holdenville, Oklahoma

Provider Information

NPI Number: 1043420227
Entity Type: Individual
Name: Itha Joyce Gray, ICADC
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Counselor - Addiction (Substance Use Disorder)
Credential: ICADC
Enumeration Date: May 23, 2007
Last Updated: Jul 8, 2007

Practice Location

Address: 118 E MAIN ST
City: Holdenville
State: Oklahoma
ZIP Code: 74848-3208
Phone: (405) 379-5256

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Counselor - Addiction (Substance Use Disorder) — Addiction (Substance Use Disorder)	101YA0400X	Primary

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