Individual
CHERYL V GRAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
L.P.C.
Contact information
Practice address
3840 HULEN ST, HTN, CLIENT ACCOUNTING, FORT WORTH, TX 76107-7277
(817) 569-4396
(817) 569-4517
Mailing address
PO BOX 2603, HTN, CLIENT ACCOUNTING, FORT WORTH, TX 76113-2603
(817) 569-4396
(817) 569-4517
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
61383
TX
101YP2500X
Professional Counselor
Primary
61383
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
191826001
—
TX
05
—
191826002
—
TX
01
—
8591LL
BCBS
TX
Enumeration date
04/02/2008
Last updated
01/24/2012
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