# ANDREA B GRAY

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1336108612
- **Gender:** F
- **Credential:** MS

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 231H00000X | Audiologist | 23002183A | IN | Yes |

## Other

- **Enumeration date:** 03/23/2006
- **Last updated:** 06/02/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 000000179545 | ANTHEM PROVIDER NUMBER | IN |
| 05 | — | 200180390 | — | IN |
| 01 | — | 9397785 | PHCS PID NUMBER | IN |
| 05 | — | HA57500064 | — | IN |