Individual
LANIQUEA GRAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
12 CLUB HOUSE DR, WILLINGBORO, NJ 08046-3404
(609) 949-1110
Mailing address
12 CLUB HOUSE DR, WILLINGBORO, NJ 08046-3404
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
26NP50047900
NJ
Other
Enumeration date
01/21/2026
Last updated
01/21/2026
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