Individual
MRS. GRACE LYNE BROTHERTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LIMHP, LMHC
Contact information
Practice address
520 N 7TH ST, COUNCIL BLUFFS, IA 51503-0709
(402) 320-8877
Mailing address
37053 HUTCHINGS AVE, HASTINGS, IA 51540-4067
(712) 621-7300
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
082103
IA
101YP2500X
Professional Counselor
10973
NE
101YP2500X
Professional Counselor
1971
NE
Other
Enumeration date
08/12/2016
Last updated
01/19/2024
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