Individual
MARLENE A GRAY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
180 TUNDRA ROAD, SELAWIK, AK 99770-0180
(907) 484-2199
(907) 484-2119
Mailing address
PO BOX 180, SELAWIK, AK 99770-0180
(907) 484-2199
(907) 484-2119
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0600402000
—
AK
Enumeration date
08/22/2017
Last updated
07/21/2022
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