Individual
ALEXIS GRAE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MC
Contact information
Practice address
5930 E PIMA ST, SUITE 208, TUCSON, AZ 85712-4370
(520) 320-1595
(520) 320-9123
Mailing address
5930 E PIMA ST, SUITE 208, TUCSON, AZ 85712-4370
(520) 320-1595
(520) 320-9123
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
LPC-2097
AZ
101YA0400X
Addiction (Substance Use Disorder) Counselor
LISAC-1552
AZ
Other
Enumeration date
10/21/2011
Last updated
10/21/2011
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