Individual
MRS. CANDICE MOREE GRAY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.A., CCC-S.L.P.
Contact information
Practice address
10510 SHADOWLAKE DR, GEISMAR, LA 70734-3329
(225) 647-7221
Mailing address
10510 SHADOWLAKE DR, GEISMAR, LA 70734-3329
(225) 647-7221
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
4906
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1301078
—
LA
Enumeration date
03/12/2007
Last updated
07/08/2007
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