Individual
GRACE SHADE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPCC
Contact information
Practice address
1234 RIDGEWOOD DR STE C, BOWLING GREEN, OH 43402-2695
(419) 408-5533
Mailing address
1234 RIDGEWOOD DR STE C, BOWLING GREEN, OH 43402-2695
(419) 408-5533
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
C.1700642
OH
101Y00000X
Counselor
Primary
E.1901560
OH
Other
Enumeration date
11/07/2017
Last updated
07/17/2023
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