Provider Demographics
NPI:1972904001
Name:GRAY, JULIE
Entity type:Individual
Prefix:
First Name:JULIE
Middle Name:
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:PO BOX 93792
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87199-3792
Mailing Address - Country:US
Mailing Address - Phone:505-750-4243
Mailing Address - Fax:
Practice Address - Street 1:3321-B CANDELARIA RD NE
Practice Address - Street 2:SUITE 403
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87107
Practice Address - Country:US
Practice Address - Phone:505-750-4243
Practice Address - Fax:505-808-4960
Is Sole Proprietor?:No
Enumeration Date:2014-09-08
Last Update Date:2024-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical