Spencer Gray
Case Manager/Care Coordinator in Mount Hope, WV. Individual provider (NPI-1).
NPI number1164031290
StatusActive
Last updated in NPPESJun 28, 2021
Details
- NPI
- 1164031290
- Entity type
- Individual (NPI-1)
- Name
- Spencer Gray
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Jul 24, 2020
- Certification date
- Jun 28, 2021
- Last updated
- Jun 28, 2021
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 171M00000X | Case Manager/Care Coordinator | – | – | Yes |
Practice location
107 N Fayette AveMount Hope, WV 25880-1202
Phone 304-252-3394
Mailing address
107 N Fayette AveMount Hope, WV 25880-1202
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