Individual
KELLEY B GRAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
BISMARCK R-V SCHOOL DISTRICT, 101 DENNIS DR, BISMARCK, MO 63624-0257
(573) 734-6111
(573) 734-2957
Mailing address
PO BOX 257, 101 DENNIS DR, BISMARCK, MO 63624-0257
(573) 734-6111
(573) 734-2957
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
01577
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
463138024
—
MO
Enumeration date
04/27/2007
Last updated
02/23/2009
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