Doctor Name: | MS. DEBORAH A GRAY |
NPI Number: | 1215955307 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LCSW, LADC, CCS |
License Number: | LC1689 |
Business Practice Address: | 37 Bangor St Ste 8 Houlton, ME - 047301739 |
Business Phone Number: | 2075329660 |
Business Fax Number: | 2075329640 |
Mailing Address: | 37 Bangor St Ste 8, P O Box 723 HOULTON |
State: | ME |
Postal Code: | 047301739 |
Phone Number: | 2075329660 |
Fax Number: | 2075329640 |
NPI Enumeration Date: | 07/17/2006 |
NPI Last Update Date: | 07/09/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YA0400X |
License Number: | LC1689 |
Healthcare Provider Taxonomy: (Secondary) | X |
State: | ME |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Addiction (Substance Use Disorder) |
Taxonomy Definition: |