Individual
KATRINA LASHELL GRAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3707 N RICHARDS ST, MILWAUKEE, WI 53212-1673
(414) 967-7006
Mailing address
3707 N RICHARDS ST, MILWAUKEE, WI 53212-1673
(414) 967-7006
Taxonomy
Speciality
Code
Description
License number
State
163WA0400X
Addiction (Substance Use Disorder) Registered Nurse
Primary
227113-30
WI
Other
Enumeration date
08/15/2016
Last updated
08/15/2016
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