Individual
SARA GRAY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ICP
Contact information
Practice address
6649 CREEKSIDE WAY, FAIRFIELD TOWNSHIP, OH 45011-7939
(901) 417-0200
Mailing address
680 GLENNA DR, FAIRFIELD, OH 45014-2719
(513) 907-8880
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
—
—
3747P1801X
Personal Care Attendant
Primary
—
—
Other
Enumeration date
01/17/2025
Last updated
01/17/2025
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