Individual
DYLAN AMELIA GRAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSW, LGSW
Contact information
Practice address
2230 COMO AVE, SAINT PAUL, MN 55108-1720
(651) 645-5323
Mailing address
3528 23RD AVE S APT 1, MINNEAPOLIS, MN 55407-3880
(774) 526-1520
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
56077
MN
Other
Enumeration date
07/03/2019
Last updated
07/03/2019
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