Provider Demographics
NPI:1982484887
Name:GRAY, ALLISON ROSE
Entity Type:Individual
Prefix:
First Name:ALLISON
Middle Name:ROSE
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 1:445 E RICHMOND DR
Mailing Address - Street 2:
Mailing Address - City:HOPE
Mailing Address - State:MI
Mailing Address - Zip Code:48628-9723
Mailing Address - Country:US
Mailing Address - Phone:989-600-0768
Mailing Address - Fax:
Practice Address - Street 1:445 E RICHMOND DR
Practice Address - Street 2:
Practice Address - City:HOPE
Practice Address - State:MI
Practice Address - Zip Code:48628-9723
Practice Address - Country:US
Practice Address - Phone:989-600-0768
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-09-29
Last Update Date:2023-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program