Individual
KATHLEEN GRAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
808 MILL LAKE RD, FORT WAYNE, IN 46845-6400
(260) 338-1241
(260) 338-1231
Mailing address
808 MILL LAKE RD, FORT WAYNE, IN 46845-6400
(260) 338-1241
(260) 338-1231
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
31004227A
IN
Other
Enumeration date
10/23/2009
Last updated
10/23/2009
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