Most Relevant Information
Provider Data
| NPI Number: | 1003664392 |
| Provider Name: | JENNIFER GRAY |
| Entity Type: | Individual |
| Taxonomy Code: | 101YS0200X |
| Specialty: | Counselor |
| License Number: | PPS-524364 |
Most Important Dates
| Enumeration Date: | 05/10/2024 |
| Last Updated: | 05/10/2024 |
Provider Practice Location
200 BERKLEY ST
ASHLAND
VA
230051329
Practice Location Phone/Fax
| Phone: | 8047233587 |
| Fax: |
Provider Mailing Location
200 BERKLEY ST
ASHLAND
VA
230051329
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |