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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.

Location: 306 Airport Dr, Moncks Corner, SC, 29461-2629
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
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
Moncks Corner
State
South Carolina
Zip
29461-2629
Phone Number
843-761-8272
Fax Number
843-719-3025
person
Provider Business Mailing Address Details
Address
306 Airport Dr
City
Moncks Corner
State
South Carolina
Zip
29461-2629
Phone Number
843-761-8272
Fax Number
843-719-3025
person
Provider's Taxonomy Details 1
Type
Other Service Providers
Classification
Peer Specialist
Speciality
-
Taxonomy
175T00000X
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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