Individual
LATASHA DANIELLE GRAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3027 W 13 MILE RD APT 339, ROYAL OAK, MI 48073-2971
(248) 761-8355
Mailing address
3027 W 13 MILE RD APT 339, ROYAL OAK, MI 48073-2971
(248) 761-8355
Taxonomy
Speciality
Code
Description
License number
State
247200000X
Other Technician
Primary
—
—
Other
Enumeration date
10/04/2016
Last updated
10/04/2016
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