Provider Demographics
NPI:1619184355
Name:GAY, MARY F (PHD)
Entity Type:Individual
Prefix:DR
First Name:MARY
Middle Name:F
Last Name:GAY
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:490 SUN VALLEY DR
Mailing Address - Street 2:SUITE 205
Mailing Address - City:ROSWELL
Mailing Address - State:GA
Mailing Address - Zip Code:30076-5615
Mailing Address - Country:US
Mailing Address - Phone:770-642-4236
Mailing Address - Fax:770-642-4239
Practice Address - Street 1:490 SUN VALLEY DR
Practice Address - Street 2:SUITE 205
Practice Address - City:ROSWELL
Practice Address - State:GA
Practice Address - Zip Code:30076-5615
Practice Address - Country:US
Practice Address - Phone:770-642-4236
Practice Address - Fax:770-642-4239
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GA0002194101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional