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General NPI Number Information
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NPI Number | 1437306222
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Entity Type | Individual
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Provider Name | GLORI GRUBBS GRAY PSYD
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Gender | Female
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Dates
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Enumeration Date | 08/22/2008
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Last Update Date | 12/13/2021
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Provider Practice Location Address
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Address Line | 1816 E 7TH ST
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City | CHARLOTTE
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State | NC
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Zip | 28204-2416
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Country | US
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Telephone | 704-313-9071
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Fax | 704-765-4749
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Provider Business Mailing Address
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Address Line | 2117 VAIL AVE
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City | CHARLOTTE
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State | NC
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Zip | 28207-1527
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Country | US
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Telephone | 503-547-5769
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Fax | 704-765-4749
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | 2482
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License Number State | OR
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