Individual
DENNIS O. GRAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CADC
Contact information
Practice address
1020 MAIN ST, LEWISTON, ID 83501-1842
(208) 750-1000
Mailing address
1020 MAIN ST, LEWISTON, ID 83501-1842
(208) 750-1000
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
11505
ID
Other
Enumeration date
03/14/2024
Last updated
03/14/2024
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