Individual
DR. ALICE MARIE GRAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PSYD
Contact information
Practice address
1740 E 17TH ST, IDAHO FALLS, ID 83404-6375
(310) 365-3762
(208) 529-3184
Mailing address
1260 GARY ST, BLACKFOOT, ID 83221-2009
(310) 365-3762
(208) 529-3184
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YM0800X
Mental Health Counselor
Primary
LCPC -4606
ID
Other
Enumeration date
06/18/2009
Last updated
11/18/2011
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