Individual
LYDIA NICOLE GRAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
5187 ROUTE 60 EAST, SUITE 11, HUNTINGTON, WV 25705
(304) 302-0526
(304) 302-0527
Mailing address
5187 ROUTE 60 EAST, SUITE 11, HUNTINGTON, WV 25705
(304) 302-0526
(304) 302-0527
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
BP00945555
WV
Other
Enumeration date
02/27/2020
Last updated
02/27/2020
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