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Individual

DONELLA OPAL GRAY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
1977 J N PEASE PL STE 104, CHARLOTTE, NC 28262-4528
(704) 274-2978
Mailing address
1977 J N PEASE PL STE 104, CHARLOTTE, NC 28262-4528
(704) 274-2978

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
LCAS-25011
NC
106S00000X
Behavior Technician

Other

Enumeration date
11/08/2017
Last updated
03/11/2019
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