Individual
MS. JODY GRAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
890 N COLE RD, BOISE, ID 83704-8638
(208) 322-1026
(208) 322-1029
Mailing address
890 N COLE RD, BOISE, ID 83704-8638
(208) 322-1026
(208) 322-1029
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LCSW30369
ID
Other
Enumeration date
06/28/2012
Last updated
06/28/2012
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