Organization
GRACEWAY PSYCHOLOGY GROUP, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
WEIMIN GRACE BLOCHER PHD (OWNER)
(217) 621-6180
Entity
Organization
Contact information
Practice address
201 W SPRINGFIELD AVE STE 211, CHAMPAIGN, IL 61820-4880
(217) 621-6180
Mailing address
PO BOX 2257, CHESTERTON, IN 46304-0357
(219) 926-8320
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
—
—
Other
Enumeration date
08/31/2015
Last updated
08/17/2018
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