Healthcare Provider Details

I. General information

NPI: 1669328811
Provider Name (Legal Business Name): JULIETTE CHARMAINE GRAY PSY.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/09/2026
Last Update Date: 03/09/2026
Certification Date: 03/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

204 E WASHINGTON ST
ANN ARBOR MI
48104-2070
US

IV. Provider business mailing address

204 E WASHINGTON ST
ANN ARBOR MI
48104-2070
US

V. Phone/Fax

Practice location:
  • Phone: 734-992-7700
  • Fax: 734-585-5634
Mailing address:
  • Phone: 734-992-7700
  • Fax: 734-585-5634

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number6301019817
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: