Individual
BEAU MARTIN GRAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LPCC
Contact information
Practice address
2001 BEAM AVE, MAPLEWOOD, MN 55109
(952) 737-4547
Mailing address
2001 BEAM AVE, MAPLEWOOD, MN 55109-1401
(952) 737-4547
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
1778
MN
Other
Enumeration date
09/20/2013
Last updated
06/12/2018
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