Individual
MRS. ELIZABETH GRAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW, RPT
Contact information
Practice address
76 PROGRESS DR STE 230D, STAMFORD, CT 06902
(203) 518-4550
Mailing address
76 PROGRESS DR STE 230D, STAMFORD, CT 06902-3600
(203) 518-4550
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
010205
CT
1041C0700X
Clinical Social Worker
149.016628
IL
222Q00000X
Developmental Therapist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1124463666
IL EARLY INTERVENTION NPI
IL
Enumeration date
05/09/2013
Last updated
05/30/2018
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