Individual
JACOB JEREMIAH GRAY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
621 S ERIE HWY, HAMILTON, OH 45011-4315
(513) 795-7557
Mailing address
2636 CINCINNATI DAYTON RD, MIDDLETOWN, OH 45044-8908
(513) 849-7469
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
05/16/2018
Last updated
05/16/2018
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