Individual
ANTONETTE PATRICE GRAY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3990 S HOWICK ST UNIT A111, MILLCREEK, UT 84107-3202
(801) 781-9183
Mailing address
PO BOX 65996, SALT LAKE CITY, UT 84165-0996
(801) 781-9183
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
—
—
374U00000X
Home Health Aide
Primary
2023PCAUT001039
UT
Other
Enumeration date
05/10/2023
Last updated
05/01/2025
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