Individual
MR. TRENT R. GRAY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCPC
Contact information
Practice address
403 W CHERRY LN, MERIDIAN, ID 83642-1610
(208) 887-1911
(208) 895-8049
Mailing address
2254 N VIEWHILL AVE, MERIDIAN, ID 83646-3794
(208) 401-8229
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
LCPC-6714
ID
Other
Enumeration date
10/17/2018
Last updated
10/17/2018
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