Individual
DENISE GRAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
475 LEXINGTON AVE, MANSFIELD, OH 44907-1501
(419) 419-5705
Mailing address
475 LEXINGTON AVE, MANSFIELD, OH 44907-1501
(419) 419-5705
Taxonomy
Speciality
Code
Description
License number
State
376G00000X
Nursing Home Administrator
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00000000000000
—
OH
Enumeration date
06/07/2021
Last updated
07/01/2021
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