NPI | 1144535915 |
---|---|
Former Name | STEPHANIE GAIL GRAY |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: IL 149.023540) |
Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: NM C-08261) |
Enumeration Date | 2010-08-17 |
Last Update Date | 2024-04-16 |