Individual
MR. JAMES WILLIAM GRAY III
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMSW
Contact information
Practice address
621 MAIN ST, STE. G, LEWISTON, ID 83501-1871
(208) 750-3000
(208) 750-1244
Mailing address
621 MAIN ST, STE. G, LEWISTON, ID 83501-1871
(208) 750-3000
(208) 750-1244
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
LMSW-31312
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
806162000
—
ID
Enumeration date
07/07/2011
Last updated
07/07/2011
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