Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TC1900X | Counseling Psychologist |
NPI | 1013443258 |
---|---|
Provider Name | Janae Raquel Sones Gray |
First Address | Wheat Ridge, CO 80033-6715 |
Second Address | Wheat Ridge, CO 80033-6715 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/05/2017 |
Last Update Date | 13/12/2021 |