Individual
JENNIFER DIANE GRAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
510 E MOELLER ST, PRESCOTT, AZ 86301
(928) 420-8300
Mailing address
825 N. 4TH ST, COTTONWOOD, AZ 86326
(530) 277-6167
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
09/08/2015
Last updated
10/25/2021
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