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Individual

DEIANEIRA GRAGE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
T-LMHC

Contact information

Practice address
417 1ST AVE. S., MOUNT VERNON, IA 52314
(319) 777-1258
Mailing address
2127 KOUNTRY LN SE APT 12, IOWA CITY, IA 52240-9319
(712) 297-0613

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
133517
IA

Other

Enumeration date
08/06/2025
Last updated
08/06/2025
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