Provider Demographics
NPI:1437459476
Name:GRAY, MELISSA KINDER (MS, LPC, LPA)
Entity type:Individual
Prefix:
First Name:MELISSA
Middle Name:KINDER
Last Name:GRAY
Suffix:
Gender:F
Credentials:MS, LPC, LPA
Other - Prefix:
Other - First Name:MISSY
Other - Middle Name:KINDER
Other - Last Name:GRAY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:3611 S SONCY RD STE 2A
Mailing Address - Street 2:
Mailing Address - City:AMARILLO
Mailing Address - State:TX
Mailing Address - Zip Code:79119-6408
Mailing Address - Country:US
Mailing Address - Phone:806-352-5542
Mailing Address - Fax:806-352-5597
Practice Address - Street 1:3611 S SONCY RD STE 2A
Practice Address - Street 2:
Practice Address - City:AMARILLO
Practice Address - State:TX
Practice Address - Zip Code:79119-6408
Practice Address - Country:US
Practice Address - Phone:806-352-5542
Practice Address - Fax:806-352-5597
Is Sole Proprietor?:Yes
Enumeration Date:2010-10-25
Last Update Date:2013-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX34945101Y00000X
TX67081101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor