Individual
ALICIA J GRAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.A.
Contact information
Practice address
3151 STILLMEADOW DR, INDIANAPOLIS, IN 46214-1529
(317) 294-5454
(317) 295-1713
Mailing address
3151 STILLMEADOW DR, INDIANAPOLIS, IN 46214-1529
(317) 294-5454
(317) 295-1713
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
200936750 A
WAIVER-32 CAPRT-F GRANT
IN
Enumeration date
04/15/2009
Last updated
05/17/2010
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