Individual
MS. MELLANEY GRAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
SLP M.S.
Contact information
Practice address
12430 TESSON FERRY RD, STE. 352, SAINT LOUIS, MO 63128-2702
(866) 495-5437
(866) 495-2445
Mailing address
1902 SEMINARY ST, ALTON, IL 62002-4788
(618) 465-7289
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
2006025368
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
463491118
—
MO
Enumeration date
02/26/2007
Last updated
07/08/2007
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