Provider Demographics
NPI:1154211340
Name:TAYLOR-GRAY, JENNIFER GAY (DSW)
Entity type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:GAY
Last Name:TAYLOR-GRAY
Suffix:
Gender:F
Credentials:DSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11730 BIG SPRING RD
Mailing Address - Street 2:
Mailing Address - City:CLEAR SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:21722-1956
Mailing Address - Country:US
Mailing Address - Phone:301-331-0082
Mailing Address - Fax:
Practice Address - Street 1:11730 BIG SPRING RD
Practice Address - Street 2:
Practice Address - City:CLEAR SPRING
Practice Address - State:MD
Practice Address - Zip Code:21722-1956
Practice Address - Country:US
Practice Address - Phone:301-331-0082
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-07-08
Last Update Date:2025-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD057151041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical