Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YM0800X | Mental Health Counselor |
NPI | 1003186271 |
---|---|
Provider Name | Mrs. Erin Patricia Gray |
First Address | Sanford, FL 32771 |
Second Address | Lake Mary, FL 32746 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 05/01/2012 |
Last Update Date | 13/12/2018 |