Provider Demographics
NPI:1063620458
Name:GRAY, ANA ELIZABETH (LBSW)
Entity type:Individual
Prefix:MRS
First Name:ANA
Middle Name:ELIZABETH
Last Name:GRAY
Suffix:
Gender:F
Credentials:LBSW
Other - Prefix:
Other - First Name:ANA
Other - Middle Name:E
Other - Last Name:GRAY
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LBSW
Mailing Address - Street 1:31769 FARM ROAD 1575
Mailing Address - Street 2:
Mailing Address - City:LOS FRESNOS
Mailing Address - State:TX
Mailing Address - Zip Code:78566
Mailing Address - Country:US
Mailing Address - Phone:956-233-4176
Mailing Address - Fax:
Practice Address - Street 1:405 E LEVEE ST
Practice Address - Street 2:
Practice Address - City:BROWNSVILLE
Practice Address - State:TX
Practice Address - Zip Code:78520-5340
Practice Address - Country:US
Practice Address - Phone:956-504-9422
Practice Address - Fax:956-542-1913
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX25501104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker