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Individual

GRACESON CLEMENTS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.ED., LCMHCA

Contact information

Practice address
6604 SIX FORKS RD STE 101, RALEIGH, NC 27615-6521
(984) 235-2545
Mailing address
3115 WAMATH DR, CHARLOTTE, NC 28210-4889

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
A20505
NC

Other

Enumeration date
09/09/2024
Last updated
09/09/2024
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