Individual
LISA GRAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
2885 W RICK DR, PORT HURON, MI 48060
(810) 300-8404
Mailing address
2885 W RICK DR, PORT HURON, MI 48060-6532
(810) 300-8404
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
6401014338
MI
Other
Enumeration date
07/10/2014
Last updated
07/18/2018
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