Individual
EBONY L GRAY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
8326 KELWOOD AVE, BATON ROUGE, LA 70806-4803
(225) 478-9685
Mailing address
402 CHARLES AVE, BAKER, LA 70714-4120
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
12/06/2021
Last updated
12/06/2021
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