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General NPI Number Information
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NPI Number | 1093413171
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Entity Type | Organization
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Legal Business Name | NATALIE GRAY LMFT
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Dates
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Enumeration Date | 02/20/2023
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Last Update Date | 02/20/2023
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Provider Practice Location Address
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Address Line | 19526 HILLSDALE DR STE B
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City | SONORA
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State | CA
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Zip | 95370-9234
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Country | US
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Telephone | 209-352-5105
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Fax |
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Provider Business Mailing Address
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Address Line | 21621 FERN LN
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City | SONORA
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State | CA
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Zip | 95370-7935
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Country | US
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Telephone | 209-352-5105
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Fax |
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Authorized Official
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Title or Position | LICENSED MARRIAGE FAMILY THERAPIST
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Name | NATALIE GRAY
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Credential |
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Telephone | 209-352-5105
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number |
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License Number State |
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