Individual
LATRICE GRAY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
775 S BONNER ST, RUSTON, LA 71270-5801
(318) 254-7050
Mailing address
775 S BONNER ST, RUSTON, LA 71270-5801
(318) 254-7050
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
473002499
NEW HORIZON COUNSELING AGENCY
—
Enumeration date
06/13/2017
Last updated
07/21/2022
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