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Individual

MR. O. DANEL LOUIS GRAY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MSW, LCSW, DCSW

Contact information

Practice address
915 N GRAND BLVD, SOCIAL WORK DIVISION, SAINT LOUIS, MO 63106-1621
(314) 652-4100
(314) 289-6597
Mailing address
5801 SIR EDWARD LN, FLORISSANT, MO 63033-7846
(314) 741-5971
(314) 741-5971

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
002054
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
002054
CLINICAL SOCIAL WORK LICE
MO
Enumeration date
09/26/2006
Last updated
07/08/2007
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