Provider Demographics
NPI:1447588835
Name:GRAY, ELIZABETH ANN (MA CCC-SLP)
Entity type:Individual
Prefix:MRS
First Name:ELIZABETH
Middle Name:ANN
Last Name:GRAY
Suffix:
Gender:F
Credentials:MA CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12411 SLAUSON AVE.
Mailing Address - Street 2:UNIT H
Mailing Address - City:WHITTIER
Mailing Address - State:CA
Mailing Address - Zip Code:90606
Mailing Address - Country:US
Mailing Address - Phone:562-693-5449
Mailing Address - Fax:562-693-5469
Practice Address - Street 1:12411 SLAUSON AVE.
Practice Address - Street 2:UNIT H, DG THERAPY GROUP
Practice Address - City:WHITTIER
Practice Address - State:CA
Practice Address - Zip Code:90606
Practice Address - Country:US
Practice Address - Phone:562-693-5449
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-11-24
Last Update Date:2009-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist