Individual
MR. GLENN EDWARD GRAY JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
539 HC 2122 W, AQUILLA, TX 76622-2495
(254) 205-0993
Mailing address
539 HC 2122 W, AQUILLA, TX 76622-2495
(254) 205-0993
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
11478
TX
Other
Enumeration date
09/03/2009
Last updated
09/03/2009
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