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General NPI Number Information
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NPI Number | 1598823445
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Entity Type | Individual
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Provider Name | BOBBIE J. GRAY L.C.S.W.
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Gender | Female
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Dates
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Enumeration Date | 12/04/2006
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Last Update Date | 12/18/2012
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Provider Practice Location Address
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Address Line | 448 REDCLIFF DR STE 215
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City | REDDING
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State | CA
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Zip | 96002-0169
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Country | US
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Telephone | 530-515-3826
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Fax | 530-222-2854
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Provider Business Mailing Address
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Address Line | 3331 HARLAN DR
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City | REDDING
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State | CA
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Zip | 96003-3318
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Country | US
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Telephone | 530-515-3826
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | LCS 20680
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License Number State | CA
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