Individual
MR. JORDAN ROBERT GRAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PRO. COUNSELOR
Contact information
Practice address
151 S UNIVERSITY AVE STE 1500, PROVO, UT 84601-4427
(801) 851-7112
Mailing address
750 N FREEDOM BLVD, PROVO, UT 84601-1677
(801) 373-4760
(801) 373-0639
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
7903342-6004
UT
101YP2500X
Professional Counselor
7903342-6009
UT
Other
Enumeration date
10/20/2011
Last updated
06/10/2020
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