Most Relevant Information
Provider Data
| NPI Number: | 1003452780 |
| Provider Name: | KIM ANTOINETTE GRAY LPC-A |
| Entity Type: | Individual |
| Taxonomy Code: | 101Y00000X |
| Specialty: | Counselor |
| License Number: |
Most Important Dates
| Enumeration Date: | 11/18/2019 |
| Last Updated: | 11/18/2019 |
Provider Practice Location
7 ELDERBUSH CT
GREENSBORO
NC
274058248
Practice Location Phone/Fax
| Phone: | 3362555085 |
| Fax: |
Provider Mailing Location
7 ELDERBUSH CT
GREENSBORO
NC
274058248
Provider Mailing Phone/Fax
| Phone: | 3362555085 |
| Fax: |