Individual
DERAVIAN GRAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1204 MCCART AVE NW, HUNTSVILLE, AL 35806-5414
(404) 394-7013
Mailing address
1204 MCCART AVE NW, HUNTSVILLE, AL 35806-5414
(404) 394-7013
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
07/08/2024
Last updated
07/08/2024
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