Individual
LYNJAVEN J GRAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
11 WOODSTONE PLZ, HATTIESBURG, MS 39402-8342
(769) 390-7234
(769) 390-7097
Mailing address
860 E RIVER PL STE 100, JACKSON, MS 39202-3442
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
08/22/2019
Last updated
08/22/2019
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