Individual
DEBRA J GRAY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
290 CARRIAGE OAKS DR, TYRONE, GA 30290-1521
(404) 226-9550
Mailing address
290 CARRIAGE OAKS DR, TYRONE, GA 30290-1521
(404) 226-9550
Taxonomy
Speciality
Code
Description
License number
State
251300000X
Local Education Agency (LEA)
Primary
85-3806492
GA
347C00000X
Private Vehicle
85-3806492
GA
Other
Enumeration date
09/07/2021
Last updated
09/07/2021
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