| Doctor Name: | LORETTE GRAY |
| NPI Number: | 1275945982 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | LCSW-C |
| License Number: | 15660 |
| Business Practice Address: | 41900 Fenwick St Leonardtown, MD - 206503814 |
| Business Phone Number: | 4014758860 |
| Business Fax Number: | 3016099091 |
| Mailing Address: | Po Box 2924, LA PLATA |
| State: | MD |
| Postal Code: | 206462984 |
| Phone Number: | 3016099887 |
| Fax Number: | 3016099091 |
| NPI Enumeration Date: | 05/29/2014 |
| NPI Last Update Date: | 05/29/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 1041C0700X |
| License Number: | 15660 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MD |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Social Worker |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | A social worker who holds a master |