Individual
MONIQUE D'LISA GRAY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
6666 GREEN VALLEY CIR, CULVER CITY, CA 90230-7068
(310) 846-5270
(310) 846-5278
Mailing address
6666 GREEN VALLEY CIR, CULVER CITY, CA 90230-7068
(310) 846-5270
(310) 846-5278
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
225700000X
Massage Therapist
Primary
82712
CA
225700000X
Massage Therapist
—
—
Other
Enumeration date
10/25/2011
Last updated
08/30/2022
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