Individual
SARA GRAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.ED., CADC
Contact information
Practice address
1044 NORTHWEST BLVD STE C, COEUR D ALENE, ID 83814-2114
(208) 930-1740
(208) 930-1695
Mailing address
1044 NORTHWEST BLVD STE C, COEUR D ALENE, ID 83814-2114
(208) 930-1740
(208) 930-1695
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
LPC-7578
ID
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
10223
ID
Other
Enumeration date
03/09/2022
Last updated
07/19/2024
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