Provider Demographics
NPI:1033983028
Name:GRAY, KAREN (CCH, CHI)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:
Last Name:GRAY
Suffix:
Gender:F
Credentials:CCH, CHI
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1491
Mailing Address - Street 2:
Mailing Address - City:WHITE RIVER JUNCTION
Mailing Address - State:VT
Mailing Address - Zip Code:05001-1491
Mailing Address - Country:US
Mailing Address - Phone:802-566-0464
Mailing Address - Fax:
Practice Address - Street 1:110 TWILIGHT CT
Practice Address - Street 2:
Practice Address - City:WHITE RIVER JUNCTION
Practice Address - State:VT
Practice Address - Zip Code:05001-8179
Practice Address - Country:US
Practice Address - Phone:802-566-0464
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-11-09
Last Update Date:2023-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171400000XOther Service ProvidersHealth & Wellness Coach