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Individual

JULIE BETH GRAY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LCSW

Contact information

Practice address
1337 GUSDORF ROAD, SUITE E, TAOS, NM 87571
(575) 758-4297
(575) 751-7237
Mailing address
107 TOALNE RD, UNIT # 3, TAOS, NM 87571-5253
(575) 770-1880

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
M-06154
NM
1041S0200X
School Social Worker
M-06154
NM

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
26523779
NM
Enumeration date
12/18/2006
Last updated
08/12/2015
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