Doctor Name: | SUSAN LOUISE GRAY |
NPI Number: | 1083707400 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | SPEECH PATHOLOGIST |
License Number: | 2868 |
Business Practice Address: | 12109 Sw 56th St Mustang, OK - 730647264 |
Business Phone Number: | 4052347079 |
Business Fax Number: | |
Mailing Address: | 12109 Sw 56th St, MUSTANG |
State: | OK |
Postal Code: | 730647264 |
Phone Number: | 4052347079 |
Fax Number: | |
NPI Enumeration Date: | 09/30/2006 |
NPI Last Update Date: | 02/01/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | 2868 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | OK |
Taxonomy Type: | Speech, Language and Hearing Service Providers |
Taxonomy Classification: | Speech-Language Pathologist |
Taxonomy Specialization: | |
Taxonomy Definition: | A speech pathologist is a person qualified by a master |