Provider Demographics
NPI:1245415421
Name:GRAY-BEATHLEY, HELENA MINETTE
Entity Type:Individual
Prefix:MS
First Name:HELENA
Middle Name:MINETTE
Last Name:GRAY-BEATHLEY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:196 COMSTOCK AVE APT 1
Mailing Address - Street 2:
Mailing Address - City:BUFFALO
Mailing Address - State:NY
Mailing Address - Zip Code:14215
Mailing Address - Country:US
Mailing Address - Phone:716-465-7596
Mailing Address - Fax:716-465-7596
Practice Address - Street 1:196 COMSTOCK AVE APT 1
Practice Address - Street 2:
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14215
Practice Address - Country:US
Practice Address - Phone:716-465-7596
Practice Address - Fax:716-465-7596
Is Sole Proprietor?:No
Enumeration Date:2008-01-07
Last Update Date:2018-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health