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Individual

MS. ATHENA D GRAY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LMHC

Contact information

Practice address
84-5210 PAINTED CHURCH RD, CAPTAIN COOK, HI 96704-8410
(808) 640-4447
Mailing address
84-5210 PAINTED CHURCH RD, CAPTAIN COOK, HI 96704-8410
(808) 640-4447

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
585
HI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
585
MENTAL HEALTH COUNSELOR STATE LICENSE NUMBER
HI
Enumeration date
07/24/2019
Last updated
07/24/2019
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