Provider Demographics
NPI:1972869105
Name:GRIGSBY, RONNI GAYLE (BA, MS)
Entity type:Individual
Prefix:MS
First Name:RONNI
Middle Name:GAYLE
Last Name:GRIGSBY
Suffix:
Gender:F
Credentials:BA, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:401 S DEWEY AVE STE 820
Mailing Address - Street 2:
Mailing Address - City:BARTLESVILLE
Mailing Address - State:OK
Mailing Address - Zip Code:74003-3542
Mailing Address - Country:US
Mailing Address - Phone:918-691-9287
Mailing Address - Fax:
Practice Address - Street 1:401 S DEWEY AVE STE 820
Practice Address - Street 2:
Practice Address - City:BARTLESVILLE
Practice Address - State:OK
Practice Address - Zip Code:74003-3542
Practice Address - Country:US
Practice Address - Phone:918-691-9287
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-04-02
Last Update Date:2024-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
OK5587101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health