Individual
LETTIE DENISE GRAY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSW,LCSW,LCAC,MAC
Contact information
Practice address
2622 LAKE AVE STE 1, FORT WAYNE, IN 46805-5410
(260) 299-3160
Mailing address
240 N TILLOTSON AVE, MUNCIE, IN 47304-3988
(765) 288-1928
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
3406620A
IN
Other
Enumeration date
06/10/2021
Last updated
07/24/2025
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