Individual
BRADIE SEQUIOA GRAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
719 W HIGHLAND AVE APT 2-5, ELGIN, IL 60123-5370
(331) 442-2717
Mailing address
719 W HIGHLAND AVE APT 2-5, ELGIN, IL 60123-5370
(331) 442-2717
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
05/31/2022
Last updated
05/31/2022
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