Individual
JENNA COLE GRAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2076 MATTIS DR, DAYTON, OH 45439-2649
(937) 901-3254
Mailing address
2076 MATTIS DR, DAYTON, OH 45439-2649
(937) 901-3254
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
CDCA.176296
OH
Other
Enumeration date
04/20/2021
Last updated
04/20/2021
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