Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TC1900X | Counseling Psychologist | PSY1001152 | DC |
NPI | 1043751217 |
---|---|
Provider Name | Dr. Melinda E Williams-Gray |
First Address | Upper Marlboro, MD 20772-5053 |
Second Address | Upper Marlboro, MD 20772-5053 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 20/03/2017 |
Last Update Date | 20/03/2017 |