Organization
GRAY PSYCHOLOGICAL SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BRYCE T. GRAY PSYD (PRESIDENT)
(816) 813-6934
Entity
Organization
Contact information
Practice address
402 B W. MT. VERNON STREET, STE 337, NIXA, MO 65714
(816) 813-6934
Mailing address
402 B W. MT. VERNON STREET, STE 337, NIXA, MO 65714
(816) 813-6934
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
2013040380
MO
Other
Enumeration date
10/21/2015
Last updated
02/26/2016
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