NPI Profile for IRVING O GRAYSON JR in FAYETTE, MS.
Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Mental Health |
101YM0800X |
| NPI Number | 1568089274 |
|
| Status | Active | |
| Credentials | ||
| Entity | Individual | |
| Enumeration date | 06/29/2020 | |
| Last updated | 05/14/2024 - About 2 years ago | |
| Sole proprietor 1 | No | |
| Identifiers | Not Available | |
| Hospital affiliation(s) | Not Available |
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IRVING O GRAYSON JR
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