Provider Demographics
NPI:1588866107
Name:GRAY, PAMELA RAE (MS)
Entity type:Individual
Prefix:
First Name:PAMELA
Middle Name:RAE
Last Name:GRAY
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3505 AVENUE O APT E
Mailing Address - Street 2:
Mailing Address - City:GALVESTON
Mailing Address - State:TX
Mailing Address - Zip Code:77550-6764
Mailing Address - Country:US
Mailing Address - Phone:409-665-8128
Mailing Address - Fax:
Practice Address - Street 1:3505 AVENUE O APT E
Practice Address - Street 2:
Practice Address - City:GALVESTON
Practice Address - State:TX
Practice Address - Zip Code:77550-6764
Practice Address - Country:US
Practice Address - Phone:409-665-8128
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-05
Last Update Date:2022-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health