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General NPI Number Information
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NPI Number | 1619945698
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Entity Type | Individual
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Provider Name | MURRAY GREY HAWKINSON LP
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Gender | Male
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Dates
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Enumeration Date | 03/08/2006
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Last Update Date | 07/22/2022
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Provider Practice Location Address
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Address Line | 132 POPLAR GROVE CONNECTOR STE B
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City | BOONE
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State | NC
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Zip | 28607-5915
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Country | US
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Telephone | 828-264-8759
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Fax | 828-264-5860
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Provider Business Mailing Address
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Address Line | 284 EXECUTIVE PARK DR STE 100
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City | CONCORD
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State | NC
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Zip | 28025-1833
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Country | US
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Telephone | 704-939-1100
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Fax | 704-939-1173
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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 | 1855
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License Number State | NC
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