Individual
CATHERINE GRAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1478 KENWOOD DR STE D1, MENASHA, WI 54952-1161
(920) 722-0311
(920) 722-0313
Mailing address
1478 KENWOOD DR STE D1, MENASHA, WI 54952-1161
(920) 722-0311
(920) 722-0313
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
15847-130
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
15847-130
WISCONSIN DHS
WI
Enumeration date
03/14/2014
Last updated
03/18/2014
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