Individual
MS. MARY L GRAY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
1322 MARTIN LUTHER KING JR AVE, GRAMBLING, LA 71245-2323
(318) 347-5974
Mailing address
1322 MARTIN LUTHER KING JR AVE, GRAMBLING, LA 71245-2323
(318) 347-5974
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
3613
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
600912252
—
LA
Enumeration date
04/28/2014
Last updated
04/28/2014
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