| Ms Amanda Breaux Gray, LMSW | |
|
1940 Laura Cir, Twin Falls, ID 83301-7009 | |
| (208) 539-4900 | |
| Not Available |
| Full Name | Ms Amanda Breaux Gray |
|---|---|
| Gender | Female |
| Speciality | Social Worker - Clinical |
| Location | 1940 Laura Cir, Twin Falls, Idaho |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1023528791 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | LCSW-39608 (Idaho) | Primary |
| Entity Name | St Lukes Clinic Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1790718229 PECOS PAC ID: 1052217478 Enrollment ID: O20031208000899 |
| Mailing Address | Practice Location Address |
|---|---|
| Ms Amanda Breaux Gray, LMSW 457 Blue Lakes Blvd S, Twin Falls, ID 83301-7855 Ph: (208) 539-4900 | Ms Amanda Breaux Gray, LMSW 1940 Laura Cir, Twin Falls, ID 83301-7009 Ph: (208) 539-4900 |
Taylor Moyle, Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 493 Eastland Dr, Twin Falls, ID 83301 Phone: 208-410-4866 | |
Amy Allison Walker, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 451 Eastland Dr, Twin Falls, ID 83301 Phone: 208-258-7681 | |
Dr. Richard Brian Keene, PHD Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 222 Shoshone St E, Twin Falls, ID 83301 Phone: 208-370-8288 | |
Garrett J Sasse, Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 801 Pole Line Rd W, Twin Falls, ID 83301 Phone: 208-814-1000 | |
Larry Kirk Hazen, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 260 2nd Ave E, Twin Falls, ID 83301 Phone: 208-732-0947 | |
Cynthia Lynn Opdycke, MSW, LCSW Clinical Social Worker Medicare: Medicare Enrolled Practice Location: 1373 Fillmore St, Twin Falls, ID 83301 Phone: 208-737-9999 Fax: 208-736-4400 |