Individual
MRS. TAMARA RAQUEL GRAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
B.S.ED.
Contact information
Practice address
112 N BROAD ST, PHILA, PA 19102-1510
(215) 568-0860
(215) 568-0769
Mailing address
1620 AFTON ST, PHILA, PA 19111-3428
(215) 342-4479
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
03/19/2007
Last updated
07/08/2007
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