Provider Demographics
NPI:1275305781
Name:GRAY, JUDITH T (PMHNP-BC)
Entity type:Individual
Prefix:
First Name:JUDITH
Middle Name:T
Last Name:GRAY
Suffix:
Gender:F
Credentials:PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1720 MERRIMAN RD UNIT N
Mailing Address - Street 2:
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44313-5280
Mailing Address - Country:US
Mailing Address - Phone:440-201-9997
Mailing Address - Fax:440-349-1786
Practice Address - Street 1:1720 MERRIMAN RD UNIT N
Practice Address - Street 2:
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44313-5280
Practice Address - Country:US
Practice Address - Phone:440-201-9997
Practice Address - Fax:440-201-9997
Is Sole Proprietor?:No
Enumeration Date:2023-10-27
Last Update Date:2025-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP61667830363LP0808X
OHAPRN.CNP.0035276363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health