Individual
KATHERINE GRAY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
153 COUNTY ROAD B019, CLEVELAND, NM 87715-8014
(505) 379-8188
Mailing address
PO BOX 395, CLEVELAND, NM 87715-0395
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
CTB-2022-0711
NM
Other
Enumeration date
12/07/2022
Last updated
12/07/2022
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