| Doctor Name: | CYD GRACE |
| NPI Number: | 1033590286 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | MA,LLPC,LBSW |
| License Number: | 6401014502 |
| Business Practice Address: | 51145 Washington St Suite E New Baltimore, MI - 480472100 |
| Business Phone Number: | 5866049101 |
| Business Fax Number: | 5866904902 |
| Mailing Address: | 51145 Washington St, Suite E NEW BALTIMORE |
| State: | MI |
| Postal Code: | 480472100 |
| Phone Number: | 5866049101 |
| Fax Number: | 5866904902 |
| NPI Enumeration Date: | 06/13/2015 |
| NPI Last Update Date: | 06/13/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YP2500X |
| License Number: | 6401014502 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MI |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Professional |
| Taxonomy Definition: | |