Individual
SHANNON MAUREEN GRAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMSW
Contact information
Practice address
190 W. MAIN ST., KUNA, ID 83634
(208) 922-9001
(208) 922-3778
Mailing address
1848 W STONE VALLEY DR, MERIDIAN, ID 83642-3578
(208) 288-1918
(208) 922-3778
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
LMSW-24699
ID
Other
Enumeration date
05/10/2007
Last updated
07/08/2007
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