Individual
MRS. KIMBERLY MICHELLE GRACE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
103 GRAY FOX XING, BONAIRE, GA 31005-3398
(478) 955-2699
Mailing address
103 GRAY FOX XING, BONAIRE, GA 31005-3398
(478) 955-2699
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
012242
GA
Other
Enumeration date
06/23/2021
Last updated
06/23/2021
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