Individual
GRACE SHILLIFF
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMHC
Contact information
Practice address
12 S MAIN ST, HOMER, NY 13077-1327
(607) 749-9256
Mailing address
5543 STATE ROUTE 281, HOMER, NY 13077-9704
(607) 749-9256
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
006443
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1336163963
—
NY
Enumeration date
09/02/2011
Last updated
03/24/2016
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