| Amy Gray Llc | |
|
1100 Fairy Falls Dr Ste 4 Coshocton OH 43812-2803 | |
| (740) 722-9416 | |
| (740) 722-9418 |
| Full Name | Amy Gray Llc |
|---|---|
| Speciality | Social Worker |
| Location | 1100 Fairy Falls Dr Ste 4, Coshocton, Ohio |
| Authorized Official Name and Position | Amy Gray (OWNER/OPERATOR) |
| Authorized Official Contact | 7407051543 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Amy Gray Llc 1100 Fairy Falls Dr Ste 4 Coshocton OH 43812-2803 Ph: (740) 722-9416 | Amy Gray Llc 1100 Fairy Falls Dr Ste 4 Coshocton OH 43812-2803 Ph: (740) 722-9416 |
| NPI Number | 1194382762 |
|---|---|
| Provider Enumeration Date | 05/20/2019 |
| Last Update Date | 09/11/2019 |
| Medicare PECOS PAC ID | 6608202924 |
|---|---|
| Medicare Enrollment ID | O20200205001965 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1194382762 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Amy L Gray |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1558424515 PECOS PAC ID: 7012918246 Enrollment ID: I20070130000595 |
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