Individual
ANN D GRAY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
149 N MAIN ST, FAIRPORT, NY 14450-1434
(585) 377-2230
Mailing address
149 N MAIN ST, FAIRPORT, NY 14450-1434
(585) 377-2230
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
005849-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
005849-1
—
NY
Enumeration date
07/31/2008
Last updated
07/31/2008
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