Provider Demographics
NPI:1235506551
Name:GRAY, LAURA SCHAFFNER (PHD)
Entity Type:Individual
Prefix:MRS
First Name:LAURA
Middle Name:SCHAFFNER
Last Name:GRAY
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:MS
Other - First Name:LAURA
Other - Middle Name:RUTH
Other - Last Name:SCHAFFNER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:P.O. BOX 37215
Mailing Address - Street 2:
Mailing Address - City:BALITMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21297-7215
Mailing Address - Country:US
Mailing Address - Phone:202-476-4224
Mailing Address - Fax:202-476-3018
Practice Address - Street 1:111 MICHIGAN AVE, NW
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20010
Practice Address - Country:US
Practice Address - Phone:202-476-4224
Practice Address - Fax:202-476-3018
Is Sole Proprietor?:No
Enumeration Date:2015-08-24
Last Update Date:2015-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD05545103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist