Individual
MARIAH LASHAE GRAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DPT, PT
Contact information
Practice address
5900 FORT DR STE 208, CENTREVILLE, VA 20121-2425
(703) 830-6360
(703) 830-6362
Mailing address
12701 FAIR LAKES CIR STE 102, FAIRFAX, VA 22033-4913
(703) 830-6360
(703) 830-6362
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
14034
TN
225100000X
Physical Therapist
28794
MD
225100000X
Physical Therapist
Primary
CP055158T
VA
225100000X
Physical Therapist
Primary
PT016317
GA
Other
Enumeration date
02/01/2022
Last updated
04/08/2026
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