Provider Demographics
NPI:1437408333
Name:GREY, ERIN DOROTHEA
Entity Type:Individual
Prefix:
First Name:ERIN
Middle Name:DOROTHEA
Last Name:GREY
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 1:447 PARK DR
Mailing Address - Street 2:APT G1
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02215-3850
Mailing Address - Country:US
Mailing Address - Phone:845-380-5724
Mailing Address - Fax:
Practice Address - Street 1:260 BEACON ST
Practice Address - Street 2:
Practice Address - City:SOMERVILLE
Practice Address - State:MA
Practice Address - Zip Code:02143-3534
Practice Address - Country:US
Practice Address - Phone:617-661-5700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-09-06
Last Update Date:2012-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)