Individual
STEPHANIE GRAY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
L.M.T., C.L.T.
Contact information
Practice address
107 OAKWOOD LN, ITHACA, NY 14850-2041
(607) 351-6840
Mailing address
107 OAKWOOD LN, ITHACA, NY 14850-2041
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
017459
NY
Other
Enumeration date
03/31/2016
Last updated
03/31/2016
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