Provider Demographics
NPI:1992139489
Name:GRAY, BESSYE K
Entity type:Individual
Prefix:
First Name:BESSYE
Middle Name:K
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 1:896 N MILL ST
Mailing Address - Street 2:SUITE 204
Mailing Address - City:LEWISVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:75057-3112
Mailing Address - Country:US
Mailing Address - Phone:866-943-7779
Mailing Address - Fax:
Practice Address - Street 1:896 N MILL ST
Practice Address - Street 2:SUITE 204
Practice Address - City:LEWISVILLE
Practice Address - State:TX
Practice Address - Zip Code:75057-3112
Practice Address - Country:US
Practice Address - Phone:866-943-7779
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-03
Last Update Date:2013-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor