Individual
MR. DAVID STEPHEN GRAY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCPC
Contact information
Practice address
20854 W GENOA AVE, LAKE VILLA, IL 60046-8957
(440) 714-8822
Mailing address
22072 W ENGLE DR, LAKE VILLA, IL 60046-5411
(440) 714-8822
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
178011708
IL
101YP2500X
Professional Counselor
Primary
180011813
IL
Other
Enumeration date
01/14/2016
Last updated
04/01/2019
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