Organization
HEATHER GRAY PROFESSIONAL COUNSELING LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. HEATHER GRAY MA, LPC, NCC (MANAGER)
(734) 558-1958
Entity
Organization
Contact information
Practice address
45739 HOLMES DR, CANTON, MI 48187-1616
(734) 926-5610
Mailing address
45739 HOLMES DR, CANTON, MI 48187-1616
(734) 558-1958
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1891063269
—
MI
Enumeration date
09/16/2019
Last updated
09/16/2019
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