Individual
TIA GRAY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2041 MARTIN LUTHER KING JR AVE SE STE 239, WASHINGTON, DC 20020-7034
(202) 547-8450
Mailing address
336 V ST NW APT 13, WASHINGTON, DC 20001-1742
(202) 459-3110
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
—
—
Other
Enumeration date
03/29/2023
Last updated
03/29/2023
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