Provider Demographics
NPI:1043514508
Name:GRAY, CATHERINE J (LMMT)
Entity Type:Individual
Prefix:MS
First Name:CATHERINE
Middle Name:J
Last Name:GRAY
Suffix:
Gender:F
Credentials:LMMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1007 U ST
Mailing Address - Street 2:
Mailing Address - City:NELIGH
Mailing Address - State:NE
Mailing Address - Zip Code:68756-1028
Mailing Address - Country:US
Mailing Address - Phone:402-851-1631
Mailing Address - Fax:
Practice Address - Street 1:1007 U ST
Practice Address - Street 2:
Practice Address - City:NELIGH
Practice Address - State:NE
Practice Address - Zip Code:68756-1028
Practice Address - Country:US
Practice Address - Phone:402-851-1631
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-12-27
Last Update Date:2010-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE2566225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist