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Individual

MS. LAQUETTA FLORENCIA GRAY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LMSW, LCSW

Contact information

Practice address
7950 MARTIN LOOP, FORT BENNING, GA 31905-5648
(706) 545-1661
Mailing address
909 FARR RD APT 17, COLUMBUS, GA 31907-6483
(706) 718-6823

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
CSW004527
GA

Other

Enumeration date
09/27/2011
Last updated
09/27/2011
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