Individual
BONNIE GRAY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4034 N 18TH ST, 3535 N 50TH STREET, MILWAUKEE, WI 53209-6802
(414) 449-5814
(414) 445-6977
Mailing address
4034 N 18TH ST, MILWAUKEE, WI 53209-6802
(414) 449-5814
(414) 445-6977
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
171W00000X
Contractor
—
—
Other
Enumeration date
11/04/2012
Last updated
11/04/2012
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