Organization
GRACE THERAPY, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TONYARAE C BOUVIER LCSW (PRACTICE OWNER)
(402) 679-2611
Entity
Organization
Contact information
Practice address
19971 BEVERLY MANOR LN, COUNCIL BLUFFS, IA 51503-5497
(402) 679-2611
Mailing address
19971 BEVERLY MANOR LN, COUNCIL BLUFFS, IA 51503-5497
(402) 679-2611
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Enumeration date
06/08/2021
Last updated
06/08/2021
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