Individual
LAURIE A GRAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2609 GLENN HENDREN DR # G100, LIBERTY, MO 64068-3313
(816) 479-4793
Mailing address
2609 GLENN HENDREN DR # G100, LIBERTY, MO 64068-3313
(816) 749-4793
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
—
MO
225XH1200X
Hand Occupational Therapist
Primary
—
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2000158034
LICENSE
MO
Enumeration date
09/19/2019
Last updated
09/19/2019
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