Individual
ALICIA MARIE GREGORY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMFT
Contact information
Practice address
111 DOLLY ST, GRAY, GA 31032-5307
(478) 491-1991
(478) 986-2337
Mailing address
276 KATHERINE DR, GRAY, GA 31032-3865
(478) 491-1991
(478) 986-2337
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
MFT001039
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
173019348A
—
GA
Enumeration date
04/27/2007
Last updated
12/04/2009
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