Provider Demographics
NPI:1215750070
Name:GRAY, JOTOYA L (PSD)
Entity type:Individual
Prefix:
First Name:JOTOYA
Middle Name:L
Last Name:GRAY
Suffix:
Gender:F
Credentials:PSD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16403 TELFAIR AVE
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44128-3739
Mailing Address - Country:US
Mailing Address - Phone:216-324-2242
Mailing Address - Fax:
Practice Address - Street 1:3043 SUPERIOR AVE E
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44114-4349
Practice Address - Country:US
Practice Address - Phone:216-307-1538
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-10-31
Last Update Date:2024-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH374J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula