Individual
SAMANTHA GRAY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA
Contact information
Practice address
753 GENEVA PKWY N UNIT 2, LAKE GENEVA, WI 53147-4579
(262) 812-0605
Mailing address
753 GENEVA PKWY N UNIT 2, LAKE GENEVA, WI 53147-4579
(224) 772-3412
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Enumeration date
08/26/2024
Last updated
11/05/2025
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