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Individual

CHANEL A GRAY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LCPC

Contact information

Practice address
10540 S WESTERN AVE STE 103, CHICAGO, IL 60643-2541
(708) 529-9544
Mailing address
109 CATERPILLAR DR APT 1B, JOLIET, IL 60436-1037

Taxonomy

Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
180.010925
IL

Other

Enumeration date
08/08/2017
Last updated
08/29/2019
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