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Individual

SHANNON GRAY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LSW

Contact information

Practice address
3900 WOODLAND AVE, PHILADELPHIA, PA 19104-4551
(215) 823-5800
Mailing address
460 RIDGEWOOD RD, MAPLEWOOD, NJ 07040-1127
(973) 908-9367

Taxonomy

Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
44SL07163700
NJ

Other

Enumeration date
02/24/2026
Last updated
02/24/2026
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