person
Mr. Mark Wayne Gray
Peer Specialist in Moncks Corner, South Carolina
NPI 1730653932

Mark Wayne Gray is a Peer Specialist based in Moncks Corner, SC. Mark Wayne Gray practices in Moncks Corner, SC. The NPI Number for Mark Wayne Gray is 1730653932 and holds a License No. (South Carolina).

The current practice location address for Mark Wayne Gray is 306 Airport Dr, Moncks Corner, SC and can be reached out via phone at 843-761-8272 and via fax at 843-719-3025. You can also correspond with Mark Wayne Gray through the mailing address at 306 AIRPORT DR, MONCKS CORNER, SC - 29461-2629 (mailing address contact number: 843-719-3018).

Location: 306 Airport Dr, Moncks Corner, SC, 29461-2629
person
Provider Profile Details
NPI Number
1730653932
Provider Name
Mark Wayne Gray
Credential
Provider Entity Type
Individual
Gender
Male
Address
306 Airport Dr, Moncks Corner, SC, 29461-2629
Phone Number
843-761-8272
Fax Number
843-719-3025
Provider Enumeration Date
01/22/2019
Last Update Date
03/10/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
1972574101 05 SC
institution
Provider Business Practice Location Address Details
Address
306 Airport Dr
City
State
Zip
29461-2629
Phone Number
843-761-8272
Fax Number
843-719-3025
person
Provider Business Mailing Address Details
Address
306 Airport Dr
City
State
Zip
29461-2629
Phone Number
843-719-3018
Fax Number
843-719-3025
person
Provider's Taxonomy Details 1
Type
Other Service Providers
Classification
Peer Specialist
Speciality
-
Taxonomy
License No.
()
Definition
Individuals certified to perform peer support services through a training process defined by a government agency, such as the Department of Veterans Affairs or a state mental health department/certification/licensing authority.
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