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General NPI Number Information
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NPI Number | 1730626060
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Entity Type | Organization
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Legal Business Name | KATHY GRAY
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Dates
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Enumeration Date | 01/25/2017
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Last Update Date | 01/25/2017
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Provider Practice Location Address
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Address Line | 1525 LAKEVILLE DR 217
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City | KINGWOOD
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State | TX
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Zip | 77339-2067
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Country | US
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Telephone | 281-223-3421
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Fax |
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Provider Business Mailing Address
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Address Line | 1525 LAKEVILLE DR 217
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City | KINGWOOD
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State | TX
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Zip | 77339-2067
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Country | US
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Telephone | 281-223-3421
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Fax |
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Authorized Official
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Title or Position | LPC, LMFT-A,
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Name | KATHY L DICKINSON GRAY
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Credential |
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Telephone | 281-223-3421
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 305R00000X
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Taxonomy Name | Preferred Provider Organization
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License Number | 70550
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License Number State | TX
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