Individual
ANGELA NECHELLE GRAY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
109 WESTROCK FARM DR, ENGLEWOOD, OH 45322-2945
(937) 751-2566
Mailing address
109 WESTROCK FARM DR, ENGLEWOOD, OH 45322-2945
(937) 751-2566
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
RV332116
OH
343900000X
Non-emergency Medical Transport (VAN)
Primary
—
—
347C00000X
Private Vehicle
RV332116
OH
376J00000X
Homemaker
RV332116
OH
385HR2060X
Child Intellectual and/or Developmental Disabilities Respite Care
RV332116
OH
Other
Enumeration date
11/30/2020
Last updated
11/30/2020
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