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General NPI Number Information
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NPI Number | 1609760727
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Entity Type | Individual
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Provider Name | JAMIE DAWN GRAY
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Gender | Female
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Dates
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Enumeration Date | 06/04/2025
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Last Update Date | 06/04/2025
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Provider Practice Location Address
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Address Line | 2028 BUFFALO TER
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City | HOUSTON
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State | TX
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Zip | 77019-2408
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Country | US
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Telephone | 979-922-5190
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Fax |
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Provider Business Mailing Address
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Address Line | 1511 TEXAS AVE S # 127
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City | COLLEGE STATION
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State | TX
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Zip | 77840-3328
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Country | US
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Telephone | 979-922-5190
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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 | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 205550
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License Number State | TX
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