Individual
MS. RONNA R GRAY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OT
Contact information
Practice address
1102 ROSE HILL DR, CHARLOTTESVILLE, VA 22903-5128
(434) 979-8628
(434) 979-8536
Mailing address
2015 TASMANIA DR, FREE UNION, VA 22940-1939
(434) 973-3835
(434) 979-8536
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
0119001252
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
189369
SOUTHERN HEALTH PROVIDER
VA
01
—
7882549
AETNA PROVIDER NUMBER
VA
Enumeration date
02/28/2007
Last updated
07/08/2007
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