Individual
MRS. TERESA LYNN GRAY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.A. CCC-SLP
Contact information
Practice address
7110 JORDAN DR, RAPID CITY, SD 57702-8738
(605) 342-4412
(605) 342-4211
Mailing address
7110 JORDAN DR, RAPID CITY, SD 57702-8738
(605) 342-4412
(605) 342-4211
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
50972-02
SD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01106843
ASHA
SD
01
—
50972-02
SD-DOE
SD
Enumeration date
10/12/2007
Last updated
10/12/2007
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