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Individual

FRED ANDERSON GRAY JR.

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
CSAC

Contact information

Practice address
681 HIOAKS RD, SUITE A, RICHMOND, VA 23225-4043
(804) 320-3626
(804) 330-5567
Mailing address
681 HIOAKS RD, SUITE A, RICHMOND, VA 23225-4043

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
0710102260
VA

Other

Enumeration date
07/20/2010
Last updated
07/20/2010
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