Individual
LATOYA GRAY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
805 LANIER AVE E, FAYETTEVILLE, GA 30214-2204
(770) 694-6349
Mailing address
805 LANIER AVE E, FAYETTEVILLE, GA 30214-2204
(770) 694-6349
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
RN282463
GA
Other
Enumeration date
03/10/2025
Last updated
03/10/2025
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