Individual
ELAINA GRAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS
Contact information
Practice address
111 W MAGNOLIA AVE, LONGWOOD, FL 32750-4130
(407) 327-1765
Mailing address
111 W MAGNOLIA AVE, LONGWOOD, FL 32750-4130
(407) 327-1765
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
IMH15718
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0000
COMMERCIAL INSURANCE
FL
Enumeration date
10/24/2017
Last updated
10/24/2017
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