Lance Malloy Grace B.S. M.A.

NPI 1114258100 - Counselor - 101Y00000X

NPI Details
NPI 1114258100
Gender Male
Enumeration Date 01/15/2010
Last Updated 01/15/2010
Entity Type Individual
Active Over 6 years ago
Practice Location
4420 N LINCOLN BLVD
OKLAHOMA CITY OK, 73105-5104, US
Phone (405) 525-0452
Fax
Business Location
2416 NW 49TH ST
OKLAHOMA CITY OK, 73112-8323, US
Phone (405) 306-0505
Fax
Toxanomy
Taxonomy Code 101Y00000X
License State
License Number
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According to our database, Mr. Lance Malloy Grace B.S. M.A. NPI is 1114258100, taxonomy code is 101Y00000X Lance Malloy Grace B.S. M.A. physically located at 4420 N Lincoln Blvd, Oklahoma City OK, 73105-5104. NPI Number Lance Malloy Grace B.S. M.A. has the Individual type.

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1114258100 NPI number is provided on an as is basis without warranty of any kind. 1114258100 is maintained by the National Plan & Provider Enumeration System. The contents of Lance Malloy Grace B.S. M.A. are for informational purposes only.