Individual
MARY AMANDA GRAY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
5306 OLD VIRGINIA STREET, URBANNA, VA 23692
(757) 814-6432
Mailing address
103 BUCKINGHAM DR, YORKTOWN, VA 23692-4504
(757) 814-6432
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
885502
VA
Other
Enumeration date
09/10/2018
Last updated
09/10/2018
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