Individual
MISS SANDRA ANN GRACE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCAS
Contact information
Practice address
3475 AIRPORT BLVD NW, STE. G, WILSON, NC 27896-8687
(252) 258-5303
(252) 281-5006
Mailing address
3475 AIRPORT BLVD NW, STE. G, WILSON, NC 27896-8687
(252) 258-5303
(252) 281-5006
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
1573
NC
104100000X
Social Worker
—
NC
Other
Enumeration date
09/02/2010
Last updated
09/02/2010
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