Individual
GRACE LILLIAN GIDLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA CMHC
Contact information
Practice address
9247 BROADWAY STE BB, MERRILLVILLE, IN 46410-7008
(219) 323-3311
Mailing address
13480 BLUE JAY LN, WHEATFIELD, IN 46392-7416
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
08/05/2022
Last updated
08/05/2022
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