| Doctor Name: | MRS. KRISTIE LYNN GRAY |
| NPI Number: | 1295784650 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | L.P.C. |
| License Number: | 19224 |
| Business Practice Address: | 205 State Highway P Potosi, MO - 636648486 |
| Business Phone Number: | 5737606206 |
| Business Fax Number: | 5734386656 |
| Mailing Address: | Po Box 128, 14363 Hwy 21 S POTOSI |
| State: | MO |
| Postal Code: | 636640128 |
| Phone Number: | 5737567859 |
| Fax Number: | 5734386656 |
| NPI Enumeration Date: | 05/10/2006 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YP2500X |
| License Number: | 19224 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | TX |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Professional |
| Taxonomy Definition: | |