Individual
JOHANNA LIDSKY GRAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CFY-SLP
Contact information
Practice address
8229 BOONE BLVD STE 660, VIENNA, VA 22182-2657
(703) 821-1363
Mailing address
31 HAYDEN LN, FRANKLIN, MA 02038-1302
(508) 269-5964
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SLPCF2000054
DC
Other
Enumeration date
09/19/2022
Last updated
09/19/2022
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