Provider Demographics
NPI:1043556152
Name:GRAY, DARIA MARIE (MS, CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:DARIA
Middle Name:MARIE
Last Name:GRAY
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:49 KAIULANI STREET
Mailing Address - Street 2:
Mailing Address - City:HILO
Mailing Address - State:HI
Mailing Address - Zip Code:96720
Mailing Address - Country:US
Mailing Address - Phone:808-961-3081
Mailing Address - Fax:808-961-6847
Practice Address - Street 1:49 KAIULANI STREET
Practice Address - Street 2:
Practice Address - City:HILO
Practice Address - State:HI
Practice Address - Zip Code:96720
Practice Address - Country:US
Practice Address - Phone:808-961-3081
Practice Address - Fax:808-961-6847
Is Sole Proprietor?:Yes
Enumeration Date:2012-12-17
Last Update Date:2023-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI1232235Z00000X
OR10614235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist