Provider Demographics
NPI:1033655972
Name:HUBER, ELIZABETH GRAY (PHD)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:GRAY
Last Name:HUBER
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5924 ROYAL LN
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75230-3863
Mailing Address - Country:US
Mailing Address - Phone:469-269-0519
Mailing Address - Fax:
Practice Address - Street 1:5924 ROYAL LN
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75230-3863
Practice Address - Country:US
Practice Address - Phone:469-269-0519
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-01-17
Last Update Date:2017-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health