Provider Demographics
NPI:1437449469
Name:GRAY, KATERI (MSW)
Entity Type:Individual
Prefix:MS
First Name:KATERI
Middle Name:
Last Name:GRAY
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:MS
Other - First Name:KATERI
Other - Middle Name:
Other - Last Name:KOWALSKI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSW
Mailing Address - Street 1:1551 FORUM PL
Mailing Address - Street 2:SUITE 400 D & E
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33401-2319
Mailing Address - Country:US
Mailing Address - Phone:561-616-8411
Mailing Address - Fax:
Practice Address - Street 1:1551 FORUM PL
Practice Address - Street 2:SUITE 400 D & E
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33401-2319
Practice Address - Country:US
Practice Address - Phone:561-616-8411
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-11
Last Update Date:2011-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker