Individual
DAVID GRAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CACP
Contact information
Practice address
124 BOARDWALK DR STE A, RIDGELAND, SC 29936-7994
(843) 645-2770
(843) 645-2771
Mailing address
124 BOARDWALK DR STE A, RIDGELAND, SC 29936-7994
(843) 645-2770
(843) 645-2771
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1760596746
—
SC
Enumeration date
02/06/2020
Last updated
11/27/2023
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