Individual
SHAWN RYAN GRAY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
1536 N JEFFERSON ST, JACKSONVILLE, FL 32209-6525
(904) 670-6900
Mailing address
1536 N JEFFERSON ST, JACKSONVILLE, FL 32209-6525
(904) 670-6900
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
18423
MD
104100000X
Social Worker
Primary
SW18511
FL
Other
Enumeration date
10/04/2012
Last updated
08/25/2022
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