Provider Demographics
NPI:1730626060
Name:KATHY GRAY
Entity type:Organization
Organization Name:KATHY GRAY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LPC, LMFT-A,
Authorized Official - Prefix:
Authorized Official - First Name:KATHY
Authorized Official - Middle Name:L
Authorized Official - Last Name:DICKINSON GRAY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:281-223-3421
Mailing Address - Street 1:1525 LAKEVILLE DR
Mailing Address - Street 2:217
Mailing Address - City:KINGWOOD
Mailing Address - State:TX
Mailing Address - Zip Code:77339-2067
Mailing Address - Country:US
Mailing Address - Phone:281-223-3421
Mailing Address - Fax:
Practice Address - Street 1:1525 LAKEVILLE DR
Practice Address - Street 2:217
Practice Address - City:KINGWOOD
Practice Address - State:TX
Practice Address - Zip Code:77339-2067
Practice Address - Country:US
Practice Address - Phone:281-223-3421
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:KATHY GRAY
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2017-01-25
Last Update Date:2017-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX70550305R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305R00000XManaged Care OrganizationsPreferred Provider Organization