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General NPI Number Information
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NPI Number | 1871150664
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Entity Type | Individual
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Provider Name | SHAREYFAH GRAY PH.D., CCC-SLP
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Gender | Female
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Dates
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Enumeration Date | 05/28/2019
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Last Update Date | 05/28/2019
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Provider Practice Location Address
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Address Line | 3335 WASHINGTON AVE
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City | BALTIMORE
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State | MD
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Zip | 21244-3605
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Country | US
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Telephone | 410-887-0708
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Fax | 410-887-0709
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Provider Business Mailing Address
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Address Line | 3511 FAIRVIEW AVE
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City | BALTIMORE
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State | MD
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Zip | 21216-1420
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Country | US
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Telephone | 410-456-7303
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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 | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | 02053
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License Number State | MD
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