Individual
MRS. ANNA CARDOSA GRAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
2302 N 15TH AVE, PHOENIX, AZ 85007-1201
(623) 242-6908
(623) 242-6909
Mailing address
4948 W PURDUE AVE, GLENDALE, AZ 85302-3530
(623) 512-6156
(800) 915-4197
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
LPT6191
AZ
2251P0200X
Pediatric Physical Therapist
LPT6191
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
811415
ARIZONA HEATHCARE COST CONTAINMENT SYSTEM (AHCCCS)
AZ
Enumeration date
08/25/2005
Last updated
03/27/2020
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