Individual
JANICE GRAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
625 W WASHINGTON AVE, MADISON, WI 53703-2637
(608) 280-2700
Mailing address
625 W WASHINGTON AVE, MADISON, WI 53703-2637
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
1197-125
WI
1041C0700X
Clinical Social Worker
3720-123
WI
163W00000X
Registered Nurse
Primary
65445-30
WI
Other
Enumeration date
09/03/2010
Last updated
09/03/2010
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