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Individual
ROGER C GRAY
Active
Individual
ROGER C GRAY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LAC, MAC, CCS, ADCII
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
1906264
SC
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
96
SC
Other
Enumeration date
06/08/2009
Last updated
01/08/2020
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