Provider Information for 1417192865
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Mrs. FAMEBRIDGE STEPHANIE GRAY LPC
Sex: Female
NPI: 1417192865
Last Updated: 2008-12-12
Certification Date:
Certification Date:
Details
| Name | Value | ||||||||
|---|---|---|---|---|---|---|---|---|---|
| NPI | 1417192865 | ||||||||
| Enumeration Date | 2008-12-12 | ||||||||
| NPI Type | NPI-1 Individual | ||||||||
| Sole Proprietor | NO | ||||||||
| Status | Active | ||||||||
| Mailing Address | 801 PENNSYLVANIA AVE SE SUITE 201 WASHINGTON, DC 20003-2167 United States Phone: 202-608-4741 | Fax:202-608-4286 | ||||||||
| Primary Practice Address | 801 PENNSYLVANIA AVE SE SUITE 201 WASHINGTON, DC 20003-2167 United States Phone: 202-608-4741 | Fax:202-608-4286 | ||||||||
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