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Organization

AM GRAY CONSULTING

Active
Other names
Reflections Image Center & Skincare Institute
Organization subpart
No

Provider details

NPI number
Authorized official
LASONDRA GRAY (MANAGING MEMBER)
(571) 337-3870
Entity
Organization

Contact information

Practice address
44125 WOODRIDGE PKWY, SUITE 220, LEESBURG, VA 20176-6839
(703) 539-6002
(703) 439-2829
Mailing address
44125 WOODRIDGE PKWY, SUITE 220, LEESBURG, VA 20176-6839
(703) 539-6002
(703) 439-2829

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
0024173992
VA
363LP2300X
Primary Care Nurse Practitioner
28154063A
IN

Other

Enumeration date
11/04/2016
Last updated
11/04/2016
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