Individual
ZACKARY GRAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
BEHAVIORAL THERAPIST
Contact information
Practice address
1174 CORNUCOPIA ST NW STE 110, SALEM, OR 97304-3193
(800) 273-4292
(714) 596-6274
Mailing address
11037 WARNER AVE # 339, FOUNTAIN VALLEY, CA 92708-4007
(714) 848-8319
(714) 596-6274
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
ABA-IN-10202002
OR
Other
Enumeration date
10/16/2019
Last updated
10/16/2019
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