Provider Demographics
NPI:1942568530
Name:GRAY, DENNIS III
Entity Type:Individual
Prefix:MR
First Name:DENNIS
Middle Name:
Last Name:GRAY
Suffix:III
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:375 N. STEPHANIE STREET
Mailing Address - Street 2:SUITE 1514
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89014
Mailing Address - Country:US
Mailing Address - Phone:702-682-9225
Mailing Address - Fax:702-465-6845
Practice Address - Street 1:375 N STEPHANIE ST
Practice Address - Street 2:SUITE 1514
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89014-8771
Practice Address - Country:US
Practice Address - Phone:702-682-9225
Practice Address - Fax:702-465-6845
Is Sole Proprietor?:No
Enumeration Date:2012-05-02
Last Update Date:2013-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor