Individual
GRACE WILCOCK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN, CLC
Contact information
Practice address
1114 E HEARNE WAY, GILBERT, AZ 85234-6018
(602) 577-6027
Mailing address
1114 E HEARNE WAY, GILBERT, AZ 85234-6018
(602) 577-6027
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
ALPP-363940
AZ
164W00000X
Licensed Practical Nurse
Primary
LP053992
AZ
Other
Enumeration date
06/05/2025
Last updated
06/05/2025
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