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Individual

KEATON GRAY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LCSW

Contact information

Practice address
777 29TH ST STE 500, BOULDER, CO 80303-2357
(908) 894-0376
Mailing address
777 29TH ST STE 500, BOULDER, CO 80303-2357
(970) 310-3406

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
CSW.09929584
CO

Other

Enumeration date
08/27/2021
Last updated
08/08/2024
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