| Doctor Name: | GREY SAMMONS |
| NPI Number: | 1417370123 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | PC |
| License Number: | C.0900620 |
| Business Practice Address: | 112 E Memorial Dr Pomeroy, OH - 457699569 |
| Business Phone Number: | 7409922192 |
| Business Fax Number: | 7409924018 |
| Mailing Address: | 3086 State Route 160, GALLIPOLIS |
| State: | OH |
| Postal Code: | 456318409 |
| Phone Number: | 7404465500 |
| Fax Number: | 7404414430 |
| NPI Enumeration Date: | 01/31/2014 |
| NPI Last Update Date: | 01/31/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YP2500X |
| License Number: | C.0900620 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | OH |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Professional |
| Taxonomy Definition: | |