Gray, Michelle Dereschuk
Gray, Michelle Dereschuk is an individual health care provider with primary practice located at 1515 N San Francisco St , Flagstaff AZ 86001-1435. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Psychologist, Behavioral Health & Social Service Providers / Marriage & Family Therapist. Behavioral Health & Social Service Providers / Psychologist is her primary health care specialty. Gray, Michelle Dereschuk can be contacted via phone (928) 774-3400.Contact Information
Primary practice address
1515 N San Francisco St
Flagstaff AZ 86001-1435
Phone: (928) 774-3400
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Psychologist | 103T00000X | 3096 | Arizona |
| Behavioral Health & Social Service Providers / Marriage & Family Therapist | 106H00000X | LMFT0324 | Arizona |
Profile Details
| NPI number | 1942417696 |
|---|---|
| LBN Legal business name | Gray, Michelle Dereschuk |
| Credentials | PH.D. |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | May 16th, 2007 |
| Last updated | Feb 13th, 2009 - about 16 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
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