Provider Demographics
NPI:1972826063
Name:MURRAY-GRAY, LYNNE
Entity Type:Individual
Prefix:
First Name:LYNNE
Middle Name:
Last Name:MURRAY-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 1:637 SPREADING OAK AVE
Mailing Address - Street 2:
Mailing Address - City:DELTONA
Mailing Address - State:FL
Mailing Address - Zip Code:32738-9003
Mailing Address - Country:US
Mailing Address - Phone:386-216-7185
Mailing Address - Fax:
Practice Address - Street 1:2101 ARC DR
Practice Address - Street 2:
Practice Address - City:ST AUGUSTINE
Practice Address - State:FL
Practice Address - Zip Code:32084-0512
Practice Address - Country:US
Practice Address - Phone:904-824-7249
Practice Address - Fax:904-824-8063
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-04
Last Update Date:2011-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst