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Individual
MR. GARY RUSSEL GRAY
Active
Individual
MR. GARY RUSSEL GRAY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MA, LMHC
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
MH 2804 FL
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
593631612
EMPLOYER TAX ID
FL
Enumeration date
05/11/2006
Last updated
06/26/2012
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