Individual ProviderJaclyn GraySocial WorkerBehavioral Health & Social Service ProvidersPractice Address45 Dimock St, Roxbury, MA 02119-1208(617) 442-8800(401) 864-1948PECOS EnrollmentBased on the most recent information from CMS, provider Jaclyn Gray does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records today at 12:07 PM.Profile DetailsProvider ID1952858144Provider TypeIndividualFull NameGray, JaclynGenderFemaleSole ProprietorNoEnumeration Date9/6/2016Last Updated9/6/2016Contact InformationPractice LocationPractice Address45 Dimock St, Roxbury, MA 02119-1208Phone(617) 442-8800FaxUnlisted FaxMailing LocationMailing Address39 Park Vale Ave, Apt. 2, Allston, MA 02134-2626Phone(401) 864-1948FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode1041C0700XPrimaryDescriptionSocial WorkerBehavioral Health & Social Service ProvidersLicenseUnlisted Issuer