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General NPI Number Information
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NPI Number | 1790208767
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Entity Type | Individual
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Provider Name | DR. BONNIE A. GRAY
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Gender | Female
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Dates
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Enumeration Date | 07/21/2017
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Last Update Date | 07/21/2017
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Provider Practice Location Address
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Address Line | 9000 E CHAPARRAL RD
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City | SCOTTSDALE
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State | AZ
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Zip | 85256-2625
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Country | US
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Telephone | 480-423-6777
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 414
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City | LAGUNA BEACH
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State | CA
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Zip | 92652-0414
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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 | 103TH0004X
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Taxonomy Name | Health Psychologist
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License Number |
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License Number State |
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