Individual
MARY LOUISE GRAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3111 WILLIAMSON COUNTY PKWY, MARION, IL 62959-5235
(618) 997-3647
(618) 969-9437
Mailing address
902 W MAIN ST, WEST FRANKFORT, IL 62896-2210
(618) 937-6483
(618) 937-1440
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
041.142634
IL
163WP0808X
Psychiatric/Mental Health Registered Nurse
Primary
041-142634
IL
Other
Enumeration date
09/28/2007
Last updated
03/27/2018
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