Provider Demographics
NPI:1851153340
Name:GRAY, SHALIN MONIQUE
Entity Type:Individual
Prefix:
First Name:SHALIN
Middle Name:MONIQUE
Last Name:GRAY
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 1:3100 FURMAN LN APT 203
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:VA
Mailing Address - Zip Code:22306-1029
Mailing Address - Country:US
Mailing Address - Phone:202-469-2187
Mailing Address - Fax:
Practice Address - Street 1:3346 HUNTLEY SQUARE DR APT 203
Practice Address - Street 2:
Practice Address - City:TEMPLE HILLS
Practice Address - State:MD
Practice Address - Zip Code:20748-6230
Practice Address - Country:US
Practice Address - Phone:202-469-2187
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-01-29
Last Update Date:2024-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD3747P1801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant