Individual
MRS. CASEY RENEE' GRAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
L.O.T.R.
Contact information
Practice address
2205 E 70TH ST, STE. 102, SHREVEPORT, LA 71105-5308
(318) 795-3388
(318) 795-3399
Mailing address
809 BRITTANY LN, BOSSIER CITY, LA 71111-2172
(318) 752-1096
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
Z12238
LA
Other
Enumeration date
02/22/2007
Last updated
07/08/2007
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