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General NPI Number Information
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NPI Number | 1467965343
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Entity Type | Individual
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Provider Name | EMMA L GRAY LSW
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Gender | Female
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Dates
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Enumeration Date | 11/14/2017
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Last Update Date | 06/27/2024
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Provider Practice Location Address
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Address Line | 10495 MONTGOMERY RD STE 20
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City | MONTGOMERY
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State | OH
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Zip | 45242-4420
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Country | US
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Telephone | 513-862-2920
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Fax |
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Provider Business Mailing Address
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Address Line | 2950 PARKWALK DR
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City | CINCINNATI
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State | OH
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Zip | 45239-1903
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Country | US
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Telephone |
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Fax |
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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 | 104100000X
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Taxonomy Name | Social Worker
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License Number | S.1600772
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | I.2203508
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License Number State | OH
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