Individual
MS. ANNA LOUISE GRAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2225 BEMISS RD STE D, VALDOSTA, GA 31602-4819
(800) 832-9419
(855) 859-1671
Mailing address
2225 BEMISS RD STE D, VALDOSTA, GA 31602-4819
(800) 832-9419
(855) 859-1671
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
19-94793
GA
Other
Enumeration date
08/06/2019
Last updated
08/06/2019
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