Individual
RAVEN GRAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
10708 ESPRIT PLACE, WHITE PLAINS, MD 20695
(443) 486-2099
Mailing address
10708 ESPRIT PLACE, WHITE PLAINS, MD 20695
(443) 486-2099
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
A3779
MD
Other
Enumeration date
03/04/2015
Last updated
03/04/2015
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